MIDC, LLC – Infectious Disease Physician, NPI 1235125717
Infectious Disease Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MIDC, LLC
McClintock Drive, Burr Ridge, Lyons Township, Cook County, Illinois, 60480, United States
STE 202
BURR RIDGE, IL 605270844
Phone: (888) 220-6432
Fax: (630) 734-4715
Type: Mailing
7901 Schatz Pointe Dr Ste D
Dayton, OH 454593824
Phone: (877) 448-3627
Fax: (866) 507-1164
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-02-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-08-31 (1014 days ago).
Enrollment records
30
Earliest due date
2023-08-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040401001608 | O | Clinic/Group Practice | IA | TBD |
| O20070323000403 | O | Clinic/Group Practice | IN | TBD |
| O20100930052971 | O | Physician - Infectious Disease | IL | 2023-08-31 |
| O20120710000753 | O | Clinic/Group Practice | MI | 2026-10-31 |
| O20130320000724 | O | Clinic/Group Practice | AZ | TBD |
| O20131119001543 | O | Clinic/Group Practice | AL | TBD |
| O20160725002739 | O | Clinic/Group Practice | FL | TBD |
| O20170105001987 | O | Clinic/Group Practice | DC | 2024-03-31 |
| O20170209000701 | O | Clinic/Group Practice | WI | TBD |
| O20170524002691 | O | Clinic/Group Practice | SC | TBD |
| O20170713000250 | O | Clinic/Group Practice | KS | 2023-08-31 |
| O20170829003039 | O | Clinic/Group Practice | GA | 2023-09-30 |
| O20180423003067 | O | Clinic/Group Practice | CA | 2024-07-31 |
| O20180719002541 | O | Clinic/Group Practice | OH | 2023-08-31 |
| O20190625002908 | O | Clinic/Group Practice | NV | 2024-10-31 |
| O20190626003536 | O | Clinic/Group Practice | TN | 2025-08-31 |
| O20190923001014 | O | Clinic/Group Practice | KY | 2025-09-30 |
| O20200220002560 | O | Clinic/Group Practice | WA | TBD |
| O20200504000320 | O | Clinic/Group Practice | OR | 2026-06-30 |
| O20200608001749 | O | Clinic/Group Practice | NE | 2026-07-31 |
| O20201222000339 | O | Clinic/Group Practice | LA | 2026-08-31 |
| O20210317000433 | O | Clinic/Group Practice | PA | TBD |
| O20210426000822 | O | Clinic/Group Practice | NM | 2026-09-30 |
| O20211019001215 | O | Clinic/Group Practice | TX | TBD |
| O20211118000568 | O | Clinic/Group Practice | OK | TBD |
| O20220218002097 | O | Clinic/Group Practice | VA | TBD |
| O20220328001192 | O | Clinic/Group Practice | CT | TBD |
| O20240809001116 | O | Clinic/Group Practice | UT | TBD |
| O20241118002166 | O | Clinic/Group Practice | MD | TBD |
| O20250226004086 | O | Clinic/Group Practice | MS | TBD |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60527)
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