Healthcare Provider Details

I. General information

NPI: 1811920986
Provider Name (Legal Business Name): MAXIM HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15303 S 94TH AVE STE 100
ORLAND PARK IL
60462-3825
US

IV. Provider business mailing address

10811 W 143RD ST STE 210
ORLAND PARK IL
60467-1944
US

V. Phone/Fax

Practice location:
  • Phone: 708-459-9121
  • Fax:
Mailing address:
  • Phone: 708-459-9121
  • Fax: 410-910-1600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1006485
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MS. DAVID KOWALCZYK
Title or Position: REGIONAL CONTROLLER
Credential:
Phone: 410-910-1500