PREMISE HEALTH OF ILLINOIS MEDICAL PC NPI 1316611445

NPI Information

NPI: 1316611445
Provider Name: PREMISE HEALTH OF ILLINOIS MEDICAL, PC

Doing Business As: ABBVIE M1

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
1401 SHERIDAN RD
NORTH CHICAGO, IL
ZIP 60064
Phone: (847) 938-8660
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PREMISE HEALTH OF ILLINOIS MEDICAL, PC is a multi-specialty clinic center in North Chicago, IL. PREMISE HEALTH OF ILLINOIS MEDICAL, PC NPI is 1316611445. The provider is registered as an organization entity type.
The provider Is Doing Business As Abbvie M1.

The provider's business location address is:

1401 SHERIDAN RD
NORTH CHICAGO, IL
ZIP 60064-803
Phone: (847) 938-8660

The provider's authorized official is William Wright .
The authorized official title is Legal Counsel and has the following contact phone number (615) 577-5893.

The CLIA number assigned to this NPI record is 14D2247147 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/3/2021 and was last updated on 8/21/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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