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General NPI Number Information
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NPI Number | 1033592365
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Entity Type | Organization
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Legal Business Name | MAXIMUS HEALTH, INC.
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Dates
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Enumeration Date | 07/06/2015
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Last Update Date | 05/16/2022
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Provider Practice Location Address
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Address Line | 6112 WOODWARD AVE
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City | DOWNERS GROVE
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State | IL
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Zip | 60516-1712
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Country | US
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Telephone | 773-732-8854
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Fax |
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Provider Business Mailing Address
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Address Line | 6112 WOODWARD AVE
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City | DOWNERS GROVE
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State | IL
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Zip | 60516-1712
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SLAWOMIR M SOJA
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Credential |
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Telephone | 773-732-8854
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172P00000X
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Taxonomy Name | Naprapath
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License Number | 181.000372
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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