NPIMap

Organization Active NPI

Premise Health of Illinois Medical, PC

Doing business as United Airlines Onsite ORD Clinic

  • Occupational Medicine Clinic/Center
  • Chicago, IL
National Provider Identifier
1518204650
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X
Legal business name
PREMISE HEALTH OF ILLINOIS MEDICAL, PC
Doing business as
United Airlines Onsite ORD Clinic
Practice address
11601 W Touhy Ave
O'Hare International Airport- Terminal 2- Lower Level
Chicago, IL 60666-5047
Phone
(770) 601-2525
Fax
(770) 601-2533
NPI assigned
Jan 9, 2013
Last updated
Aug 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Authorized official

Name
Dr. Jon Leizman, MD
Title
President
Phone
(615) 468-6270

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Clinic/Center 261QX0100X Primary

Addresses

Primary practice location

11601 W Touhy Ave
O'Hare International Airport- Terminal 2- Lower Level
Chicago, IL 60666-5047

Mailing address

5500 Maryland Way
Brentwood, TN 37027-4948
Phone (888) 830-4255

Other names 1

  • United Airlines Onsite ORD Clinic Doing business as

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

NPI Registry JSON

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

{
    "created_epoch": "1357689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692576000000",
    "number": "1518204650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274948",
            "telephone_number": "888-830-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11601 W TOUHY AVE",
            "address_2": "O'HARE INTERNATIONAL AIRPORT- TERMINAL 2- LOWER LEVEL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606665047",
            "telephone_number": "770-601-2525",
            "fax_number": "770-601-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF ILLINOIS MEDICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-09",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A",
        "authorized_official_last_name": "LEIZMAN",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-468-6270",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "United Airlines Onsite ORD Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "United Airlines Onsite ORD Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.