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Organization
PREMISE HEALTH OF ILLINOIS MEDICAL PC
Active
Organization
PREMISE HEALTH OF ILLINOIS MEDICAL PC
Active
Other names
Premise Health Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN B LEIZMAN MD (PRESIDENT)
(216) 479-9063
Entity
Organization
Contact information
Practice address
131 S DEARBORN ST STE 1035, CHICAGO, IL 60603-5517
(312) 487-2141
(312) 577-0767
Mailing address
5500 MARYLAND WAY STE 120, BRENTWOOD, TN 37027-4993
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
02/20/2025
Last updated
02/20/2025
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