Individual
PAUL MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 E MILLER RD, STERLING, IL 61081-1252
(815) 625-4790
Mailing address
101 E MILLER RD, STERLING, IL 61081-1252
(815) 625-4790
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102802
HEALTH ALLIANCE MEDICAL
IL
01
—
9815737
BLUE CROSS BLUE SHIELD
IL
01
—
P00188707
RAILROAD MEDICARE
—
Enumeration date
10/12/2006
Last updated
12/03/2007
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