Healthcare Provider Details

I. General information

NPI: 1356255905
Provider Name (Legal Business Name): MAXWELL EVAN PFLEDDERER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7913 GOLF RD
MORTON GROVE IL
60053-1040
US

IV. Provider business mailing address

7913 GOLF RD
MORTON GROVE IL
60053-1040
US

V. Phone/Fax

Practice location:
  • Phone: 847-803-8162
  • Fax: 847-803-8162
Mailing address:
  • Phone: 847-803-8162
  • Fax: 847-803-8162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number3659
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: