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MAXWELL ETHAN EDMONDS
NPI 1306238142
Student in an Organized Health Care Education/Training Program in Chicago, IL

Active since March 03, 2015PECOS Enrolled
3324 N CLIFTON AVE APT 2F, CHICAGO, IL 60657(401) 480-1194 Get Directions Write a Review

NPPES record last updated: June 5, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Maxwell Ethan Edmonds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAXWELL ETHAN EDMONDS (NPI 1306238142) is an individual student in an organized health care education/training program in Chicago, Illinois and active in the NPI registry since March 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1306238142
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMAXWELL ETHAN EDMONDS
Location Address3324 N CLIFTON AVE APT 2FChicago, IL 60657-2285
Mailing Address3324 N Clifton Ave Apt 2fChicago, IL 60657-2285 · (401) 480-1194
Phone(401) 480-1194
Sole ProprietorYes
Enumeration DateMarch 3, 2015
Last NPPES UpdateJune 5, 2022
NPPES CertifiedJune 5, 2022
✔ NPI 1306238142 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
3324 N CLIFTON AVE APT 2F, Chicago, IL 60657
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Maxwell Ethan Edmonds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KUANGHUA GUO MD, PHD
Internal Medicine
3324 N CLIFTON AVE APT 2F
CHICAGO, IL 60657
Cook County (917) 773-9943

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Maxwell Edmonds's NPI number?

The NPI number for Maxwell Edmonds is 1306238142. It was assigned to this individual provider in the NPPES registry on March 3, 2015.

Where is Maxwell Edmonds located?

Maxwell Edmonds practices at 3324 N Clifton Ave Apt 2F, Chicago, IL 60657. The listed phone number is (401) 480-1194.

What is Maxwell Edmonds's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Maxwell Edmonds enrolled in Medicare?

Yes. Maxwell Edmonds is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Maxwell Edmonds was last updated on June 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.