Provider Demographics
NPI:1063730083
Name:HENDREN, BRYAN PHILLIP (MD)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:PHILLIP
Last Name:HENDREN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:9650 GROSS POINT RD STE 3900
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-5085
Mailing Address - Country:US
Mailing Address - Phone:847-570-1700
Mailing Address - Fax:847-982-1098
Practice Address - Street 1:9650 GROSS POINT RD STE 3900
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-5085
Practice Address - Country:US
Practice Address - Phone:847-570-1700
Practice Address - Fax:847-982-1098
Is Sole Proprietor?:No
Enumeration Date:2010-05-14
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD043247208600000X, 2086S0127X
IL0361583082086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery