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Organization
METRO INFECTIOUS DISEASE CONSULTANTS, LLC
Active
Organization
METRO INFECTIOUS DISEASE CONSULTANTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA KOWALSKI (CREDENTIALING MANAGER)
(888) 220-6432
Entity
Organization
Contact information
Practice address
901 MC CLINTOCK DRIVE, SUITE 202, BURR RIDGE, IL 60527-0844
(630) 655-6742
(630) 734-4715
Mailing address
901 MC CLINTOCK DRIVE, SUITE 202, BURR RIDGE, IL 60527-0844
(888) 220-6432
(630) 734-4715
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RI0200X
Infectious Disease Physician
Primary
—
NULL
207RI0200X
Infectious Disease Physician
Primary
—
—
207RR0500X
Rheumatology Physician
—
NULL
207RR0500X
Rheumatology Physician
—
—
Other
Enumeration date
04/01/2010
Last updated
12/13/2013
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