PREMISE HEALTH OF ILLINOIS MEDICAL PC
NPI 1629716121
Clinic/Center - Multi-Specialty in Northbrook, IL
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, 2028 and lists Edward William Schwartz, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Premise Health Of Illinois Medical Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
64Medicare enrollment records show 64 clinicians reassign Medicare billing to Premise Health Of Illinois Medical PC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 7 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 7
Nearest to this location (20)
See all 64Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, ILFrequently 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. The provider is doing business as Premise Health Wellness Center.
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.
Is Premise Health Of Illinois Medical PC enrolled in Medicare?
Yes. Premise Health Of Illinois Medical PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Premise Health Of Illinois Medical PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 64 clinicians in 7 Medicare specialties reassign their Medicare billing to Premise Health Of Illinois Medical PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (32), Family Practice (13) and Physical Therapist in Private Practice (9). Of these, 1 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, 2028. 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 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.
# Premise Health Of Illinois Medical Pc · NPI 1629716121
Multi-Specialty organization in Northbrook, Illinois. Organization record, active in the CMS NPPES registry since May 24, 2022.
## Identity
- **NPI:** 1629716121 (Entity type: Organization)
- **Enumerated:** May 24, 2022
- **Primary specialty:** Clinic/Center - Multi-Specialty · taxonomy 261QM1300X
- **Also known as:** Premise Health Wellness Center (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Edward Schwartz, PRESIDENT
## Practice location
- **Address:** 4179 DUNDEE RD STE A106, Northbrook, IL 60062-2129
- **Phone:** (847) 402-2300
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 64 clinicians in 7 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (32), Family Practice (13), Physical Therapist in Private Practice (9); 1 practice at this address and 7 within 10 miles; [full list](https://npiprofile.com/npi/1629716121/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 13, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1629716121) · Data from the CMS NPPES public registry.