Anna    Leurck    NP
Contract Details
Metro Infectious Disease Consultants
Facility name
Provider ID
P000000001
NPI
1922623453
Tax ID
363966745
Effective Date
8/10/2022
Last Updated
8/15/2022
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
107.00
Fee Schedule Multiplier
Location Details
Address
6345 Airport Boulevard Suite J
Mobile, AL 36608
United States
Phone
877-448-3627 (Phone)
Billing Details
Address
6345 Airport Boulevard
Suite J
Burr Ridge, IL 36608
Billing Phone
630-655-6748
Specialty Type
Nurse Practitioner, Family
Map
Address