Active NPI
Daniel Maksimovich, M.D.
- Anesthesiology Physician
- Chicago, IL
National Provider Identifier
1932450285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 036.087570
- Practice address
- 3407 W Fullerton Ave
Chicago, IL 60647-2497 - Phone
- (630) 400-4881
- Fax
- (312) 929-3739
- NPI assigned
- Sep 26, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 036.087570 | IL | Primary |
Addresses
Primary practice location
3407 W Fullerton Ave
Chicago, IL 60647-2497
Mailing address
200 W Menomonee St
Unit 4
Chicago, IL 60614-5313
Phone (312) 475-1203
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.087570 | IL | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452643200000",
"number": "1932450285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 W MENOMONEE ST",
"address_2": "UNIT 4",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606145313",
"telephone_number": "312-475-1203",
"fax_number": "312-929-3739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3407 W FULLERTON AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606472497",
"telephone_number": "630-400-4881",
"fax_number": "312-929-3739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAKSIMOVICH",
"first_name": "DANIEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-09-26",
"last_updated": "2016-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IL",
"license": "036.087570",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.