Premise Health of Illinois Medical, PC

NPI #1588940019 in Northbrook, Illinois

Provider Information

NPI Number: 1588940019
Entity Type: Organization
Organization Name: Premise Health of Illinois Medical, PC
Primary Specialty: General Practice
Enumeration Date: Oct 28, 2011
Last Updated: Aug 21, 2023

Practice Location

Address: 2775 SANDERS RD
Address 2: SUITE C1
City: Northbrook
State: Illinois
ZIP Code: 60062-6110
Phone: (703) 760-0700

Authorized Official

Name: DR. JON LEIZMAN, MD
Title: PRESIDENT
Phone: (615) 468-6270

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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