Provider Demographics
NPI:1972616092
Name:NAYDEN, MAX EDWARD (PT)
Entity type:Individual
Prefix:MR
First Name:MAX
Middle Name:EDWARD
Last Name:NAYDEN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11540 W 183RD PL UNIT A
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467
Mailing Address - Country:US
Mailing Address - Phone:708-310-6733
Mailing Address - Fax:708-221-0092
Practice Address - Street 1:19801 GOVERNORS HWY STE 100
Practice Address - Street 2:
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-4363
Practice Address - Country:US
Practice Address - Phone:708-647-1500
Practice Address - Fax:708-647-1800
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070010910225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
576490Medicare ID - Type Unspecified