Healthcare Provider Details

I. General information

NPI: 1639011539
Provider Name (Legal Business Name): DANIEL & MAX, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2026
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 MEIJER DR
ROLLING MEADOWS IL
60008-4205
US

IV. Provider business mailing address

1615 S CONGRESS AVE STE 105
DELRAY BEACH FL
33445-6326
US

V. Phone/Fax

Practice location:
  • Phone: 847-593-2406
  • Fax: 847-593-2449
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: ALISHA JACKSON
Title or Position: MANAGED CARE MANAGER
Credential:
Phone: 561-208-1591