Mount Vernon Healthy Living Center
LBN: Premise Health Of Illinois Medical, Pc
Mount Vernon Healthy Living Center is an health care organization with primary practice located at 5100 Lake Terrance Ne , Mount Vernon IL 62864-9665. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Primary Care, Ambulatory Health Care Facilities / Occupational Medicine. Ambulatory Health Care Facilities / Primary Care is the primary health care specialty.
Premise Health Of Illinois Medical, Pc can be contacted via phone (618) 899-5001, or through Leizman, Jon via phone (216) 479-9063.
Contact Information
Primary practice address
5100 Lake Terrance Ne
Mount Vernon IL 62864-9665
Phone: (618) 899-5001
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X | ||
| Ambulatory Health Care Facilities / Occupational Medicine | 261QX0100X |
Profile Details
| NPI number | 1427366921 |
|---|---|
| LBN Legal business name | Premise Health Of Illinois Medical, Pc |
| DBA Doing business as | Mount Vernon Healthy Living Center |
| Authorized official | Leizman, Jon Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 17th, 2010 |
| Last updated | Aug 17th, 2023 - about last year |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
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