Allison Marie Petrak, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

085004546 Issued in IL

Practice address

901 McClintock Drive
Suite 202
Burr Ridge, IL 60527-0872

Phone

(888) 220-6432

Fax

(630) 734-4715

NPI assigned

Dec 10, 2012

Last updated

Dec 17, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 4

Medicare fee-for-service enrollment

Enrolled in IL, WI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metro Infectious Disease Consultants LLCGroup PAC ID 3072425784, 386 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Metro Infectious Disease Consultants, LLC

  dba Midc, LLC

  • Infectious Disease Physician
  • Burr Ridge, IL
  • NPI 1235125717
  Medicare reassignment Care Compare group NPD
• Ascension Medical Group-Southeast Wisconsin Inc

  dba Ascension Medical Group

  • Internal Medicine Physician
  • Glendale, WI
  • NPI 1609881077
  Medicare reassignment NPD
• Metro Infectious Disease Consultants LLC

  dba Midc

  • Infectious Disease Physician
  • Jonesboro, GA
  • NPI 1770307191
  NPD
• Metro Infectious Disease Consultants LLC

  • Community/Retail Pharmacy
  • Burr Ridge, IL
  • NPI 1184610396
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1355097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1558606053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 MCCLINTOCK DRIVE",
            "address_2": "SUITE 202",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605270872",
            "telephone_number": "888-220-6432",
            "fax_number": "630-734-4715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MCCLINTOCK DRIVE",
            "address_2": "SUITE 202",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605270872",
            "telephone_number": "888-220-6432",
            "fax_number": "630-734-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRAK",
        "first_name": "ALLISON",
        "middle_name": "MARIE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-10",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085004546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN COOK",
            "identifier": "347710028",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apetrak276008@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "901 McClintock Drive",
            "address_2": "Suite 202",
            "city": "Burr Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605270872",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "901 McClintock Drive",
            "address_2": "Suite 202",
            "city": "Burr Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605270872",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apetrak@midcusa.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "901 McClintock Drive",
            "address_2": "Suite 202",
            "city": "Burr Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605270872",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://protect-us.mimecast.com/s/efVTC31YJ3skyYMtDy8G-",
            "affiliation": "N",
            "address_1": "901 McClintock Drive",
            "address_2": "Suite 202",
            "city": "Burr Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605270872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Peak Behavioral Health
• Plamen D Penev, MD
• Danielle Perk, LCSW
• Todd A Permut, MD
• Melissa Jeanne Marie Peterson, CNM
• Robert Petrak, MD
• Russell M Petrak, MD
• Elaine O Petrof, MD
• Theresa Petru
• Pharmscript of Il LLC

• Medical Physician Assistant in Burr Ridge, IL
• Providers in Burr Ridge, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.