Provider Demographics
NPI:1659149508
Name:MAXI HEALTHCARE PC
Entity Type:Organization
Organization Name:MAXI HEALTHCARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:TOBI
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:ADEBOYEJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:331-275-6095
Mailing Address - Street 1:1632 W COLONIAL PKWY
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:IL
Mailing Address - Zip Code:60067-4725
Mailing Address - Country:US
Mailing Address - Phone:331-275-6095
Mailing Address - Fax:
Practice Address - Street 1:1632 W COLONIAL PKWY
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:IL
Practice Address - Zip Code:60067-4725
Practice Address - Country:US
Practice Address - Phone:331-275-6095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care