Anna    Leurck    NP
Contract Details
Metro Infectious Disease Consultants
Facility name
Provider ID
P000000001
NPI
1922623453
Tax ID
363966745
Effective Date
3/16/2023
Last Updated
3/17/2023
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
107.00
Fee Schedule Multiplier
Location Details
Address
20 Hughes Road Suite 202
Madison, AL 35758
United States
Phone
888-220-6432 (Phone)
Billing Details
Address
901 McClinktock Drive
Suite 202
Burr Ridge, IL 60527
Billing Phone
6306556748
Specialty Type
Nurse Practitioner
Map
Address