Individual
DR. BRENT MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
546 S RANDALL RD STE F, ST CHARLES, IL 60174-5914
(630) 443-0400
(630) 922-2424
Mailing address
2625 BUTTERFIELD RD, SUITE 301N, OAK BROOK, IL 60523-1234
(630) 320-6400
(630) 701-1007
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038011973
IL
111N00000X
Chiropractor
3379
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085X1
BCBS
NC
Enumeration date
03/01/2007
Last updated
07/23/2015
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