Midc Pharmacy

LBN: Metro Infectious Disease Consultants Llc
Midc Pharmacy is an health care organization with primary practice located at 901 Mcclintock Dr Suite 104, Burr Ridge IL 60527-0844. The organization recently has 2 registered licenses in different health care specialties including Agencies / Home Infusion, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Metro Infectious Disease Consultants Llc can be contacted via phone (630) 986-4580, or through Petrak, Russell Martin via phone (630) 986-4580.

Contact Information

Primary practice address
901 Mcclintock Dr Suite 104 Burr Ridge IL 60527-0844
Phone: (630) 986-4580
Fax: (630) 528-9600
Website:
Map and Directions
Authorized official contact:
Name: Petrak, Russell Martin Doctor of Medicine (MD)
Phone: (630) 986-4580

Health care specialties

SpecialtyCodeLicense #State
Agencies / Home Infusion 251F00000X 054-015148 Illinois
Suppliers / Community/Retail Pharmacy 3336C0003X 054015148 Illinois

Profile Details

NPI number 1184610396
LBN Legal business name Metro Infectious Disease Consultants Llc
DBA Doing business as Midc Pharmacy
Authorized official Petrak, Russell Martin Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 Yes
Enumeration date Sep 22nd, 2005
Last updated Mar 7th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184610396 NPPES
Illinois Other 032-008061 CONTROLLED SUBSTANCE

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