NPIMap

Organization Active NPI

Premise Health of Illinois Medical PC

Doing business as Carpenters Center for Health

  • Multi-Specialty Clinic/Center
  • Lisle, IL
National Provider Identifier
1073025235
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PREMISE HEALTH OF ILLINOIS MEDICAL PC
Doing business as
Carpenters Center for Health
Macrc
Practice address
4979 Indiana Ave Ste 312
Lisle, IL 60532
Phone
(312) 337-4150
Fax
(312) 337-4311
NPI assigned
Oct 27, 2017
Last updated
Jan 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 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
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

4979 Indiana Ave Ste 312
Lisle, IL 60532

Mailing address

5500 Maryland Way Ste 120
Brentwood, TN 37027-4993

Other names 2

  • Carpenters Center for Health Doing business as
  • MACRC 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
14D2138631Premise Health of Illinois Medical, SC4979 Indiana Ave - Ste 312, Lisle, IL 60532Certificate of waiverOct 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
Premise Health of Illinois Medical PC24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

Locations

4979 Indiana Ave
Ste 312
Lisle, IL 60532
Phone (312) 337-4150

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1509062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769644800000",
    "number": "1073025235",
    "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": "4979 INDIANA AVE STE 312",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "60532",
            "telephone_number": "312-337-4150",
            "fax_number": "312-337-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF ILLINOIS MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-27",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "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": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carpenters Center for Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MACRC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.