METRO INFECTIOUS DISEASE CONSULTANTS, LLC (NPI# 1427619386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427619386 |
| Entity Type | Organization |
| Organization Name | METRO INFECTIOUS DISEASE CONSULTANTS, LLC |
| Practice Address |
4601 W 109th St Ste 100 Overland Park KS 66211-1313 |
| Mailing Address |
901 Mcclintock Dr Ste 202 Burr Ridge IL 60527-0872 |
| Practice Telephone | 9139420540 |
| Practice Fax Number | 6305289589 |
| Mailing Telephone | 6302206432 |
| Mailing Fax Number | 6306544253 |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2019-06-21 |
| Authorized Official Name | RUSSELL M PETRAK (MANAGING PARTNER) |
| Authorized Official Telephone | 8882206432 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 201170330A | 05 |
| Other Name | Type Code |
|---|---|
| MIDC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598242778 | Metro Infectious Disease Consultants, LLC | Internal Medicine | 2340 E Meyer Blvd Ste 348, Kansas City, MO 64132-1129 | 2018-07-20 |
| 1659702223 | Metro Infectious Disease Consultants, LLC | Internal Medicine | 1102 Monroe St Sw, Huntsville, AL 35801-5029 | 2013-12-09 |
| 1073854600 | Metro Infectious Disease Consultants, LLC | Internal Medicine | 13657 W Mcdowell Rd, Suite 118, Goodyear, AZ 85395-2601 | 2013-03-06 |
| 1841530250 | Metro Infectious Disease Consultants, LLC | Home Infusion | 15474 N Haggerty Rd, Plymouth, MI 48170-4893 | 2013-02-21 |
| 1649510033 | Metro Infectious Disease Consultants, LLC | Pharmacy | 6704 Benjamin Rd, Suite 700, Tampa, FL 33634-4408 | 2013-02-21 |
| 1669797734 | Metro Infectious Disease Consultants, LLC | Internal Medicine | 901 Mc Clintock Drive, Suite 202, Burr Ridge, IL 60527-0844 | 2010-04-01 |
| 1215184916 | Metro Infectious Disease Consultants, LLC | Home Infusion | 901 Mcclintock Drive, Suite 202, Burr Ridge, IL 60527-0844 | 2008-08-25 |
| 1235125717 | Metro Infectious Disease Consultants, LLC | Clinic/Center | 901 Mcclintock Dr, Suite 202, Burr Ridge, IL 60527-0844 | 2005-09-21 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | METRO INFECTIOUS DISEASE CONSULTANTS, LLC | 901 Mcclintock Drive, Burr Ridge, IL 60527 |
| Indiana Business Entities | METRO INFECTIOUS DISEASE CONSULTANTS, LLC | 901 Mcclintock Dr, Burr Ridge, IL 60527 |
| Street Address |
4601 W 109TH ST STE 100 |
| City | OVERLAND PARK |
| State | KS |
| Zip Code | 66211-1313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174587422 | Michael R Driks | Internal Medicine | 4601 W 109th St Ste 100, Overland Park, KS 66211-1313 | 2006-04-13 |
| 1639778913 | Dania Stainbrook | Nurse Practitioner | 4601 W 109th St Ste 100, Overland Park, KS 66211-1313 | 2020-10-19 |
| 1164060554 | Angela E Crawford | Nurse Practitioner | 4601 W 109th St Ste 100, Overland Park, KS 66211-1313 | 2019-12-16 |
| 1225230485 | Teera Chentanez | Internal Medicine | 4601 W 109th St Ste 100, Overland Park, KS 66211-1313 | 2007-06-01 |
| 1740497122 | Apoorv Yashpal Kalra | Internal Medicine | 4601 W 109th St Ste 100, Overland Park, KS 66211-1313 | 2007-05-17 |
| 1699878504 | Himal B Bajracharya | Internal Medicine | 4601 W 109th St Ste 100, Overland Park, KS 66211-1313 | 2006-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336611821 | Baillie Rose Woydziak | Social Worker | 5805 W 110th Street, Overland Park, KS 66211 | 2018-12-20 |
| 1467920389 | Ku Medwest Ambulatory Surgery Center, LLC | Clinic/Center | 10720 Nall Avenue, Overland Park, KS 66211 | 2018-11-08 |
| 1235615931 | Janice Carollo | Physical Therapy Assistant | 11611 Granada Lane, Leawood, KS 66211 | 2018-07-16 |
| 1720572555 | Trevor Lee Elmer | Physical Therapist | 10777 Nall, 320 - Corporate Medical Plaza Building II, Overland Park, KS 66211 | 2018-06-15 |
| 1043746555 | Overland Park Surgical Suites, LLC | Clinic/Center | 6650 W 110th St Ste 300, Overland Park, KS 66211 | 2017-05-03 |
| 1619313665 | Vcphcs Xiv, LLC | Clinic/Center | 6331 W. 110th Street, Overland Park, KS 66211 | 2013-05-17 |
| 1528334950 | Scott Anthony Hardouin | Surgery | 5100 W 110th St Unit 300, Overland Park, KS 66211 | 2012-03-29 |
| 1386917003 | Children's Physical Therapy Associates | Physical Therapist | 6600 College Boulevard, Suite 307, Overland Park, KS 66211 | 2012-02-10 |
| 1871876250 | Amber Diane Dalzell | Social Worker | 10965 Granada Ln Ste 102, Overland Park, KS 66211 | 2011-09-22 |
| 1912298001 | Stephen Vincent Hiatt | Orthopaedic Surgery | 10701 Nall Avenue, Suite 200, Overland Park, KS 66211 | 2011-04-25 |
| Find all providers in zip 66211 | ||||
| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174587422 | Michael R Driks | Internal Medicine | 4601 W 109th St Ste 100, Overland Park, KS 66211-1313 | 2006-04-13 |
| 1508208083 | Glenn Ross Hodges | Internal Medicine | 7171 W 95th St, Overland Park, KS 66212-2283 | 2013-07-24 |
| 1225230485 | Teera Chentanez | Internal Medicine | 4601 W 109th St Ste 100, Overland Park, KS 66211-1313 | 2007-06-01 |
| 1740497122 | Apoorv Yashpal Kalra | Internal Medicine | 4601 W 109th St Ste 100, Overland Park, KS 66211-1313 | 2007-05-17 |
| 1528289469 | William Howard Downham Jr. | Internal Medicine | 7311 W 132nd St, Suite 200, Overland Park, KS 66213-1134 | 2007-05-01 |
| 1689752909 | John S Fried | Internal Medicine | 8800 W 75th St, Suite 300, Overland Park, KS 66204-2205 | 2006-11-02 |
| 1962580183 | John S Fried, Md | Internal Medicine | 8800 W 75th St, Suite 300, Overland Park, KS 66204-2205 | 2006-11-02 |
| 1699878504 | Himal B Bajracharya | Internal Medicine | 4601 W 109th St Ste 100, Overland Park, KS 66211-1313 | 2006-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629523287 | Raed Jabr | Internal Medicine | 3952 Adams St Apt 12, Kansas City, KS 66103-2958 | 2016-08-23 |
| 1952662926 | Siddhi Anil Mankame | Internal Medicine | 901 Sw Garfield Ave Fl 2, Topeka, KS 66606-1670 | 2012-06-06 |
| 1215162110 | Jacob Taylor Hodges | Internal Medicine | 737 E. Crawford St., Salina, KS 67401 | 2009-05-20 |
| 1992885610 | C Michael West Md LLC | Internal Medicine | 5700 Sw 38th St., Topeka, KS 66610-1252 | 2006-10-17 |
| 1861598344 | Prapas Gerjarusak | Internal Medicine | 11709 Norwood Dr, Leawood, KS 66211-3003 | 2006-09-15 |
| 1952417644 | Samir Desai | Internal Medicine | 7255 Renner Rd, Shawnee, KS 66217-3043 | 2006-08-22 |
| 1659354736 | Fernando Merino | Internal Medicine | 3901 Rainbow Boulevard, 6067 Delp, Mail Stop 1028, Kansas City, KS 66160 | 2005-11-22 |
| 1407851181 | Thomas A. Moore | Internal Medicine | 1100 N Saint Francis St, Suite 130, Wichita, KS 67214-2878 | 2005-06-17 |
| 1255984456 | Hutchinson Regional Medical Center, Inc. | Internal Medicine | 1701 E 23rd Ave, Hutchinson, KS 67502-1105 | 2019-07-17 |
| 1043664675 | Rinda Mousa | Internal Medicine | 3901 Rainbow Boulevard, 6070 Delp Ms 1028, Kansas City, KS 66160 | 2016-04-20 |
| Find all providers with the same taxonomy | ||||
| City | OVERLAND PARK |
| Zip Code | 66211 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.