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Organization
METRO INFECTIOUS DISEASE CONSULTANTS, LLC
Active
Organization
METRO INFECTIOUS DISEASE CONSULTANTS, LLC
Active
Other names
MIDC, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL M PETRAK MD (MANAGING PARTNER)
(888) 220-6432
Entity
Organization
Contact information
Practice address
901 MCCLINTOCK DR, SUITE 202, BURR RIDGE, IL 60527-0844
(888) 220-6432
(630) 734-4715
Mailing address
901 MCCLINTOCK DR, STE 202, BURR RIDGE, IL 60527-0844
(888) 220-6432
(630) 734-4715
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
0000920-2
IL
261QI0500X
Infusion Therapy Clinic/Center
—
NULL
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
09/21/2005
Last updated
07/30/2024
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