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:
Authorized official contact:
Name: Petrak, Russell Martin Doctor of Medicine (MD)
Phone: (630) 986-4580
Health care specialties
| Specialty | Code | License # | 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 last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184610396 | NPPES |
| Illinois | Other | 032-008061 | CONTROLLED SUBSTANCE |
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