Provider Demographics
NPI:1144240987
Name:MAXIMUM HOSPICE & PALLIATIVE CARE, INC.
Entity Type:Organization
Organization Name:MAXIMUM HOSPICE & PALLIATIVE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MUBARAK
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:MIRJAT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:708-952-1900
Mailing Address - Street 1:2959 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-2409
Mailing Address - Country:US
Mailing Address - Phone:708-952-1900
Mailing Address - Fax:708-952-9010
Practice Address - Street 1:2959 W 95TH ST
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2409
Practice Address - Country:US
Practice Address - Phone:708-952-1900
Practice Address - Fax:708-952-9010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1715334251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2002392Medicaid
IL2002392Medicaid