PREMISE HEALTH OF ILLINOIS MEDICAL, PC is a multi-specialty clinic center in Chicago, IL. PREMISE HEALTH OF ILLINOIS MEDICAL, PC NPI is 1235584475. The provider is registered as an organization entity type.
The provider Is Doing Business As Premise Health Clinic.
The provider's business location address is:
TERMINAL 3, K19 CONCOURSE, RAMP LEVEL RM 100
TOUHY & MT PROSPECT RD
CHICAGO, IL
ZIP 60666
Phone: (773) 686-3912
Fax: (773) 686-4662
The provider's authorized official is Jon Leizman .
The authorized official title is President and has the following contact phone number (216) 479-9063.
The CLIA number assigned to this NPI record is 14D2051627 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 4/25/2016 and was last updated on 8/21/2023.