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PREMIER MD
NPI 1093411001
Family Medicine in Edwardsville, IL

Active since February 01, 2023
15 SUGAR CREEK LN, EDWARDSVILLE, IL 62025(618) 510-9123(618) 822-4095 Get Directions Write a Review

NPPES record last updated: January 9, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Jan 9, 2026, Feb 1, 2023 (2 updates tracked since 2023).

About Premier Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PREMIER MD (NPI 1093411001) is a healthcare organization registered as a family medicine in Edwardsville, Illinois and active in the NPI registry since February 2023. The organization lists Glenn Skow, Ceo, as its authorized official.

NPPES Registry Identity

NPI1093411001
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePREMIER MD
Location Address15 SUGAR CREEK LNEdwardsville, IL 62025-3322
Mailing Address15 Sugar Creek LnEdwardsville, IL 62025-3322 · (618) 510-9123 · Fax (618) 822-4095
Phone(618) 510-9123
Fax(618) 822-4095
Organization SubpartNo
Authorized OfficialGlenn SkowCeo · (917) 514-8740
Enumeration DateFebruary 1, 2023
Last NPPES UpdateJanuary 9, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 9, 2026
✔ NPI 1093411001 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
15 SUGAR CREEK LN, Edwardsville, IL 62025
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Other Identifiers 1

Medicaid036130323IL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Premier MD's NPI number?

The NPI number for Premier MD is 1093411001. It was assigned to this organization in the NPPES registry on February 1, 2023.

Where is Premier MD located?

Premier MD is located at 15 Sugar Creek Ln, Edwardsville, IL 62025. The listed phone number is (618) 510-9123.

What is Premier MD's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Premier MD was last updated on January 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.