MEDICARE: DR. ROBERT MAXSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	036148794	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194036632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT MAXSON M.D.

Provider Business Mailing Address
First Line	:	12255 S 80TH AVE STE 204
Second Line	:
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-1284
Country	:	US
Telephone Number	:	708-923-3388
Fax Number	:	708-923-3380

Provider Business Practice Location Address
First Line	:	12255 S 80TH AVE STE 204
Second Line	:
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-1284
Country	:	US
Telephone Number	:	708-923-3388
Fax Number	:	708-923-3380

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2010
Last Update Date	:	12/29/2022

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Directions to “ DR. ROBERT MAXSON M.D.” Practice Location

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