Organization
METRO INFECTIOUS DISEASE CONSULTANTS, LLC
Active
Other names
MIDC, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
TARA KOWALSKI (CREDENTIALING MANAGER)
(888) 220-6432
Entity
Organization
Contact information
Practice address
901 MCCLINTOCK DRIVE, SUITE 202, BURR RIDGE, IL 60527-0844
(888) 220-6432
(630) 654-4253
Mailing address
901 MCCLINTOCK DRIVE, SUITE 202, BURR RIDGE, IL 60527-0844
(888) 220-6432
(630) 654-4253
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
Primary
054015148
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1634065
BLUE CROSS/ BLUE SHIELD
IL
Enumeration date
08/25/2008
Last updated
03/07/2023
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