Provider Demographics
NPI:1518285790
Name:MAXIMUM MEDICAL, INC
Entity Type:Organization
Organization Name:MAXIMUM MEDICAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXANDR
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERNYAVSKIY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-307-1888
Mailing Address - Street 1:1200 HUNTINGTON DR
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-3206
Mailing Address - Country:US
Mailing Address - Phone:847-307-1888
Mailing Address - Fax:
Practice Address - Street 1:1200 HUNTINGTON DR
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-3206
Practice Address - Country:US
Practice Address - Phone:847-307-1888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL12204PT343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)