Healthcare Provider Details

I. General information

NPI: 1659149508
Provider Name (Legal Business Name): MAXI HEALTHCARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2023
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1632 W COLONIAL PKWY
INVERNESS IL
60067-4725
US

IV. Provider business mailing address

1632 W COLONIAL PKWY
INVERNESS IL
60067-4725
US

V. Phone/Fax

Practice location:
  • Phone: 331-275-6095
  • Fax:
Mailing address:
  • Phone: 331-275-6095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TOBI SAMUEL ADEBOYEJO
Title or Position: RN
Credential:
Phone: 331-275-6095