PREMISE HEALTH WELLNESS CENTER
NPI 1477881845
Clinic/Center - Health Service in Chicago, IL
NPI Status: Active since November 24, 2009
Contact Information
300 E RANDOLPH ST # CL404
CHICAGO, IL
ZIP 60601
Phone: (312) 653-3300
Fax: (312) 653-3398
- Organization
- Clinic/Center
- Health Service
- Accepts Insurance
- CLIA Number: 14D2002385
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-13-2026
About PREMISE HEALTH WELLNESS CENTER
This page provides the complete NPI Profile along with additional information for Premise Health Wellness Center, a provider established in Chicago, Illinois operating as a Clinic/center, focusing in health service . The healthcare provider is registered in the NPI registry with number 1477881845 assigned on November 2009. The practitioner's primary taxonomy code is 261QH0100X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Premise Health Wellness Center. The authorized official of this NPI record is Dr. Jon Leizman Md (President)
- NPI
- 1477881845
- Provider Legal Name
- PREMISE HEALTH OF ILLINOIS MEDICAL, PC
- Other Organization Name
- PREMISE HEALTH WELLNESS CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 300 E RANDOLPH ST # CL404 CHICAGO, IL 60601
- Location Phone
- (312) 653-3300
- Location Fax
- (312) 653-3398
- Mailing Address
- 5500 MARYLAND WAY STE 120 BRENTWOOD, TN 37027
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-24-2009
- Last Update Date
- 08-21-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Health Service
- Taxonomy Code
- 261QH0100X
- Type
- Ambulatory Health Care Facilities
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- UHC Bronze Copay Focus (No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Value (Rx Copay, No Referrals) - HMO
- UHC Bronze Value+ (Rx Copay, Dental + Vision, No Referrals) - HMO
- UHC Gold Advantage (No Referrals) - HMO
- UHC Gold Advantage+ (Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus (No Referrals) - HMO
- UHC Gold Standard (Rx Copay, No Referrals) - HMO
- UHC Silver Advantage (Rx Copay, No Referrals) - HMO
- UHC Silver Advantage+ (Rx Copay, Dental + Vision, No Referrals) - HMO
- UHC Silver Copay Focus (No Referrals) - HMO
- UHC Silver Standard (No Referrals) - HMO
- UHC Silver Standard+ (Dental + Vision, No Referrals) - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 14D2002385
- Facility Type
- Physician Office
- Certificate Effective Date
- January 14, 2024
- Certificate Expiration Date
- January 13, 2026
- Laboratory Director
- JAMES THOMAS BARRETT
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Premise Health Wellness Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for PREMISE HEALTH WELLNESS CENTER
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 7 | 7 | 8 | 8 | 1 | 8 | 4 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 14 | 7 | 16 | 8 | 2 | 8 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 1 + 4 + 7 + 1 + 6 + 8 + 2 + 8 + 8 + 24 = 75 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 75 = 5 | 5 | ||||||||
The NPI number 1477881845 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1477881845, enumerated as an "organization" on November 24, 2009.
The provider is located at 300 E RANDOLPH ST # CL404 CHICAGO, IL 60601 and the phone number is (312) 653-3300.
Clinic/Center with taxonomy code 261QH0100X and a focus in Health Service.
The provider might be accepting Accepts: UnitedHealthcare. Please consult your insurance carrier or call the provider to verify.
