Healthcare Provider Details

I. General information

NPI: 1467555961
Provider Name (Legal Business Name): MAXIM HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

973 FEATHERSTONE RD SUITE 210
ROCKFORD IL
61107-5912
US

IV. Provider business mailing address

973 FEATHERSTONE RD STE 210
ROCKFORD IL
61107-5911
US

V. Phone/Fax

Practice location:
  • Phone: 815-484-0000
  • Fax: 815-484-0001
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1010450
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: DAVID KOWALCZYK
Title or Position: CONTROLLER
Credential:
Phone: 410-910-1500