1. Home
  2. Directory
  3. Illinois
  4. Northbrook
  5. Clinic Center
  6. NPI Profile

PREMISE HEALTH OF ILLINOIS MEDICAL PC
NPI 1629716121
Clinic/Center - Multi-Specialty in Northbrook, IL

Active since May 24, 2022CLIA 14D2265598 · Waiver
4179 DUNDEE RD STE A106, NORTHBROOK, IL 60062(847) 402-2300 Get Directions Write a Review

NPPES record last updated: February 13, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Nov 15, 2023, Aug 21, 2023, Aug 15, 2022 and 1 more (4 updates tracked since 2022).

About Premise Health Of Illinois Medical Pc NPPES

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

PREMISE HEALTH OF ILLINOIS MEDICAL PC (NPI 1629716121), doing business as Premise Health Wellness Center, is a healthcare organization registered as a multi-specialty in Northbrook, Illinois and active in the NPI registry since May 2022. The organization holds a CLIA Waiver certificate valid through July 28, 2026 and lists Edward William Schwartz, President, as its authorized official.

NPPES Registry Identity

NPI1629716121
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NamePREMISE HEALTH OF ILLINOIS MEDICAL PC
Location Address4179 DUNDEE RD STE A106Northbrook, IL 60062-2129
Mailing Address5500 Maryland Way Ste 120Brentwood, TN 37027-4993
Phone(847) 402-2300
Organization SubpartNo
Authorized OfficialEdward William SchwartzPresident · (844) 407-7557
Enumeration DateMay 24, 2022
Last NPPES UpdateFebruary 13, 20264 updates tracked since enumeration
NPPES CertifiedFebruary 13, 2026
✔ NPI 1629716121 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
4179 DUNDEE RD STE A106, Northbrook, IL 60062
Open in Google Maps ↗

Other Names 1

Doing Business AsPremise Health Wellness Center

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2265598

Premise Health Of Illinois Medical, S C · Northbrook, IL
Active · expires Jul 28, 2026
CLIA Number14D2265598
Laboratory TypePhysician Office
Certificate Effective DateJuly 29, 2024
Certificate Expiration DateJuly 28, 2026
Laboratory DirectorJohann Serag
Laboratory Phone(847) 402-2300
Laboratory LocationPremise Health Of Illinois Medical, S C4179 Dundee Rd - Ste A106, Northbrook, IL 60062
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHARYN HYMES FNP
Family Medicine
4179 DUNDEE RD STE A106
NORTHBROOK, IL 60062
Cook County (847) 402-2300

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 Premise Health Of Illinois Medical PC's NPI number?

The NPI number for Premise Health Of Illinois Medical PC is 1629716121. It was assigned to this organization in the NPPES registry on May 24, 2022.

Where is Premise Health Of Illinois Medical PC located?

Premise Health Of Illinois Medical PC is located at 4179 Dundee Rd Ste A106, Northbrook, IL 60062. The listed phone number is (847) 402-2300.

What is Premise Health Of Illinois Medical PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Does Premise Health Of Illinois Medical PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2265598) is associated with this NPI, valid through July 28, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Premise Health Of Illinois Medical PC was last updated on February 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.