MEDICARE: MAXIM HEALTHCARE SERVICES, INC.

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	253Z00000X	In Home Supportive Care Agency
2	385H00000X	Respite Care
3	251E00000X	Home Health Agency	1010406	IL
4	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1578666079
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAXIM HEALTHCARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	7227 LEE DEFOREST DRIVE
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21046
Country	:	US
Telephone Number	:	410-910-1500
Fax Number	:	410-910-1600

Provider Business Practice Location Address
First Line	:	4450 N PROSPECT RD STE S8
Second Line	:
City	:	PEORIA HEIGHTS
State	:	IL
Zip	:	61616-6578
Country	:	US
Telephone Number	:	309-566-0800
Fax Number	:

Authorized Official
Title or Position	:	CONTROLLER
Name	:	DAVID KOWALCZYK
Credential	:
Telephone Number	:	410-910-1500

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	10/16/2025

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