1932387156 NPI number — MAXIM STAFFING

Table of content: REBEKAH CATHERINE HARRINGTON NP (NPI 1386198133)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932387156 NPI number — MAXIM STAFFING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MAXIM STAFFING
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932387156
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/11/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2340 S. RIVER RD.
Provider Second Line Business Mailing Address:
SUITE 109
Provider Business Mailing Address City Name:
DES PLAINES
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60018
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-297-2005
Provider Business Mailing Address Fax Number:
847-297-9896

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2340 RIVER RD
Provider Second Line Business Practice Location Address:
STE 109
Provider Business Practice Location Address City Name:
DES PLAINES
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-297-2005
Provider Business Practice Location Address Fax Number:
847-297-9896
Provider Enumeration Date:
02/11/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
THOMAS
Authorized Official First Name:
MATTHEW
Authorized Official Middle Name:
Authorized Official Title or Position:
RECRUITER
Authorized Official Telephone Number:
847-297-2005

Provider Taxonomy Codes

  • Taxonomy code: 251J00000X , with the licence number:  41288247 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)