Provider Demographics
NPI:1134554744
Name:MAXOVER, LLC
Entity type:Organization
Organization Name:MAXOVER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHILAWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-424-8900
Mailing Address - Street 1:141 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62523-1212
Mailing Address - Country:US
Mailing Address - Phone:217-424-4344
Mailing Address - Fax:217-233-1119
Practice Address - Street 1:141 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62523-1212
Practice Address - Country:US
Practice Address - Phone:217-424-4344
Practice Address - Fax:217-233-1119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty