EXCLUDEDPROVIDER
Individual Revocation

Theodore H Hendrickson

Fairfield, CT 06430

Public HHS-OIG LEIE exclusion record

According to the HHS-OIG List of Excluded Individuals/Entities (LEIE), Theodore H Hendrickson of Fairfield, CT is currently excluded from participation in federally funded health care programs due to license revocation, suspension, or surrender, as of September 1, 1994.

Status
Currently listed by HHS-OIG
Record type
Individual
Location
Fairfield, CT 06430
Exclusion date
September 1, 1994
Exclusion type
Revocation (1128b4)
Source dataset
May 2026

Record summary

Theodore H Hendrickson appears in the HHS-OIG List of Excluded Individuals/Entities (LEIE) public dataset as an individual record associated with Fairfield, Connecticut. The latest imported LEIE dataset lists this record as currently excluded from participation in federally funded health care programs. The exclusion date shown in the source record is September 1, 1994, and the exclusion type is 1128b4, identified by HHS-OIG as license revocation, suspension, or surrender.

Source record

SourceHHS-OIG LEIE (public dataset)
Record typeIndividual
Current statusCurrently listed by HHS-OIG
Exclusion dateSeptember 1, 1994
Exclusion typeLicense revocation, suspension, or surrender (1128b4)
UPINB38664
Source dataset dateMay 2026

What this exclusion type means

HHS-OIG identifies exclusion type 1128b4 as “License revocation, suspension, or surrender.” License revocation, suspension, or surrender (permissive exclusion).

This exclusion type is a statutory category used by HHS-OIG in the LEIE dataset. The category describes the legal authority associated with the exclusion record, not a separate investigation or additional reporting by Excluded Provider.

Location and provider classification

This LEIE record is associated with Fairfield, CT 06430. The listed provider category is Medical Practice, MD. The listed specialty is Internal Medicine.

Other excluded providers in Fairfield, CT

Other individuals and entities currently listed in the HHS-OIG LEIE public dataset with a Fairfield, CT address.

Darrell Evans Individual Suspension
Fairfield, CT · Exclusion or suspension under a federal or state health care program · Excluded Feb 2010
John R Zatkowski Individual Revocation
Fairfield, CT · License revocation, suspension, or surrender · Excluded Feb 1995
Mary Wargo Individual Revocation
Fairfield, CT · License revocation, suspension, or surrender · Excluded Aug 1991
Edward M Keelan Individual Revocation
Fairfield, CT · License revocation, suspension, or surrender · Excluded Apr 1989
Anthony Testo Individual Program Crime
Fairfield, CT · Conviction of program-related crimes · Excluded Jul 1986

How to verify this record

This page is a public-record summary and should be treated as a possible LEIE match, not final identity verification. To verify the record, use the official HHS-OIG LEIE search and compare available identifying information through the official process. Name, location, provider category, specialty, exclusion date, and NPI should be treated as matching clues rather than final proof of identity.

What this page does not include

This page summarizes the HHS-OIG LEIE public dataset only. It does not search state Medicaid exclusion lists, state licensing-board actions, court records, malpractice records, employment history, civil lawsuits, or non-public investigations.

Verify with HHS-OIG Remove / correct this record

Related

More excluded individuals in Connecticut More records in Fairfield More license revocation, suspension, or surrender records