NPIMap

Organization Active NPI

Premise Health of Illinois Medical, PC

Doing business as Walgreens Healthy Living Center Deerfield

  • Primary Care Clinic/Center
  • Deerfield, IL
National Provider Identifier
1033494976
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PREMISE HEALTH OF ILLINOIS MEDICAL, PC
Doing business as
Walgreens Healthy Living Center Deerfield
Walgreens Healthy Living Health Center
Practice address
108 Wilmot Rd
Deerfield, IL 60015-5145
Phone
(847) 580-0002
Fax
(847) 374-0207
NPI assigned
Oct 11, 2011
Last updated
Jan 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Edward William Schwartz
Title
President
Phone
(844) 407-7557

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

108 Wilmot Rd
Deerfield, IL 60015-5145

Mailing address

5500 Maryland Way Ste 120
Brentwood, TN 37027-4993

Other names 2

  • Walgreens Healthy Living Center Deerfield Doing business as
  • Walgreens Healthy Living Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120423000619 IL Part B Supplier - Clinic/Group Practice 3971764762 Receives reassigned benefits from 75 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Countryside, IL; Utica, IL; Northbrook, IL; Mount Vernon, IL; Lisle, IL; Joliet, IL; Grayslake, IL; Elgin, IL…

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2032932Premise Health of Illinois Medical, SC108 Wilmot Rd, Deerfield, IL 60015Certificate of waiverJul 20, 2027

National Provider Directory

National Provider Directory

Locations

300 E Randolph St
#404
Chicago, IL 60601
Phone (312) 653-3300

300 E Randolph St
Fl CL404
Chicago, IL 60601

5100 Lake Ter NE
Ste Wc
Mount Vernon, IL 62864
Phone (618) 899-5001

1401 Sheridan Rd
North Chicago, IL 60064
Phone (847) 938-8660

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769558400000",
    "number": "1033494976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY STE 120",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 WILMOT RD",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155145",
            "telephone_number": "847-580-0002",
            "fax_number": "847-374-0207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF ILLINOIS MEDICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-11",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A",
        "authorized_official_last_name": "SCHWARTZ",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "844-407-7557"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walgreens Healthy Living Center Deerfield",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Walgreens Healthy Living Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Walgreens Healthy Living Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Deerfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.