Organization
PREMISE HEALTH OF ILLINOIS MEDICAL, PC
Active
Other names
Mylan Institutional Inc
Organization subpart
No
Provider details
NPI number
Authorized official
JON LEIZMAN MD (PRESIDENT)
(615) 468-6270
Entity
Organization
Contact information
Practice address
5500 MARYLAND WAY, BRENTWOOD, TN 37027-4948
(888) 830-4255
Mailing address
5500 MARYLAND WAY, BRENTWOOD, TN 37027-7048
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
09/30/2015
Last updated
08/21/2023
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