Maxicare Visiting Physician, Inc

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

MAXICARE VISITING PHYSICIAN, INC

Practice address

3300 W Peterson Ave
Suite H
Chicago, IL 60659

Phone

(773) 961-7580

NPI assigned

Jul 18, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nelson Mercado

Title

Office Manager

Phone

(773) 961-7580

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500336000000",
    "number": "1245753755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 W PETERSON AVE STE H",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 W PETERSON AVE",
            "address_2": "SUITE H",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60659",
            "telephone_number": "773-961-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXICARE VISITING PHYSICIAN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-18",
        "last_updated": "2017-07-18",
        "status": "A",
        "authorized_official_last_name": "MERCADO",
        "authorized_official_first_name": "NELSON",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "773-961-7580"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blake Eddy Max, PHARMD
• Madison Max
• Maxcare Pharmacy
• Amethyst Maxey, FNP-C
• Maxicare Home Health Services, Inc.
• Rafiah Maxie, LCSW
• Maxima Health and Wellness LLC
• Maxmath Tutoring Online Inc., Illinois Branch
• Kate Lynn Maxouris, M.D.
• Maxwell Physical Therapy, LLC

• Health Service Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Health Service Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.