# METRO INFECTIOUS DISEASE CONSULTANTS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MIDC, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235125717
- **Authorized official:** DR. RUSSELL M PETRAK MD (MANAGING PARTNER)
- **Authorized official phone:** (888) 220-6432

## Contact information

- **Practice address:** 901 MCCLINTOCK DR, SUITE 202, BURR RIDGE, IL 60527-0844
- **Practice address phone:** (888) 220-6432
- **Practice address fax:** (630) 734-4715
- **Mailing address:** 901 MCCLINTOCK DR, STE 202, BURR RIDGE, IL 60527-0844
- **Mailing address phone:** (888) 220-6432
- **Mailing address fax:** (630) 734-4715

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | 0000920-2 | IL | Yes |
| 261QI0500X | Infusion Therapy Clinic/Center | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 09/21/2005
- **Last updated:** 07/30/2024