OrganizationActive
Innovative Physician Associates LLC
NPI 1336482462 · Health Maintenance Organization · Burr Ridge, IL
Provider details
- NPI number
- 1336482462
- Entity type
- Organization
- Primary specialty
- Health Maintenance OrganizationManaged Care Organizations
- Parent organization
- Metro Infectious Disease Consultants,llc
- Organization subpart
- Yes
- Authorized official
- Russell Petrak, Managing Partner(888) 220-6432
- License
- 41053311 (IL)
Specialties & taxonomies
Managed Care Organizations
Practice location
901 Mcclintock Drive
Suite 202
Burr Ridge, IL 60527-0844
Phone: (888) 220-6432
Fax: (630) 734-4715
Approximate (ZIP-level) locationGet directions
Mailing address
901 Mcclintock Drive
Burr Ridge, IL 60527-0844
Registry dates
- Enumerated
- 2013-03-27
- Last updated
- 2013-03-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.