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General NPI Number Information
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NPI Number | 1326589151
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Entity Type | Organization
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Legal Business Name | MAXWELL ROVNER, M.D. S.C.
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Dates
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Enumeration Date | 03/13/2017
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Last Update Date | 03/13/2017
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Provider Practice Location Address
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Address Line | 1344 N. DEARBORN PKWY. APT. 13A
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City | CHICAGO
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State | IL
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Zip | 60610-6061
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Country | US
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Telephone | 312-375-3101
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Fax | 312-664-1625
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Provider Business Mailing Address
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Address Line | 30 N. MICHIGAN AVE. SUITE 1004
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City | CHICAGO
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State | IL
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Zip | 60602-3750
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Country | US
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Telephone | 312-508-3475
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Fax | 312-275-7955
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MAXWELL RABSON ROVNER
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Credential | M.D.
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Telephone | 312-508-3475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036.136228
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License Number State | IL
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