Metro Primary Care Associates LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

METRO PRIMARY CARE ASSOCIATES LLC

Practice address

13755 S. Cicero Ave
Crestwood, IL 60445-1824

Phone

(708) 972-7642

Fax

(708) 925-9179

NPI assigned

Oct 2, 2013

Organization subpart

No

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

Authorized official

Name

Ashley Rock

Title

Director of Clinical Operations

Phone

(708) 972-7636

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Metro Infectious Disease Consultants LLC Other name

Electronic endpoints 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Russell M Petrak, MD

  • Infectious Disease Physician
  • Burr Ridge, IL
  • NPI 1376539692
  NPD

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

{
    "created_epoch": "1380672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1811324064",
    "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": "605270844",
            "telephone_number": "888-220-6432",
            "fax_number": "630-654-4253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13755 S. CICERO AVE",
            "city": "CRESTWOOD",
            "state": "IL",
            "postal_code": "604451824",
            "telephone_number": "708-972-7642",
            "fax_number": "708-925-9179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO PRIMARY CARE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-02",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A",
        "authorized_official_last_name": "ROCK",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL OPERATIONS",
        "authorized_official_telephone_number": "708-972-7636"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "F100106060",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lfochesattofilho283947@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "13755 S. Cicero Ave",
            "city": "Crestwood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604451824",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "13755 S. Cicero Ave",
            "city": "Crestwood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604451824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Metro Infectious Disease Consultants LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Metro Infectious Disease Consultants LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ashley Lauren McGowan, SLP
• Medication Management Partners
• Richard Melton, LCSW
• Brian Mendoza, D.C.
• Mimoza Metarapi, PHARMD, BCPS, BCGP
• Michael a. Luckett D.M.D. & Associates (Rivercrest), LTD.
• Midwest Physician Group LTD
• Miinedoctor, Inc.
• Maxime David Morier-Roy, OD
• Morris Esformes & Melvin Segal Etal

• Internal Medicine Physician in Crestwood, IL
• Providers in Crestwood, IL by specialty
• Internal Medicine Physician 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 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.