Healthcare Provider Details

I. General information

NPI: 1912415654
Provider Name (Legal Business Name): DR. SEAN CHRISTOPHER MAXWELL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2018
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4345 KIRKWOOD HWY STE 201
WILMINGTON DE
19808-5131
US

IV. Provider business mailing address

2001 BUTTERFIELD RD STE 1600
DOWNERS GROVE IL
60515-1211
US

V. Phone/Fax

Practice location:
  • Phone: 302-635-9009
  • Fax: 302-449-2047
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberJ1-0003850
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: