Frequently Asked Questions

The load factor is the percentage added to your usable square footage to arrive at the rentable square footage you actually pay rent on.

It covers your proportional share of the building's common areas, such as lobbies, corridors, and shared restrooms. It typically ranges from about 10 to 20%, so 20% sits at the high end but is not automatically a bad deal: a higher load factor can reflect genuine amenities your patients use, like accessible lobbies and ample parking. What matters is comparing total cost, not the rate alone. A 20% load factor on a 2,000 usable square foot suite means you pay on 2,400 rentable square feet. Always ask for both the usable and rentable figures, and the factor between them, before comparing spaces.

At minimum, negotiate enough free rent (rent abatement) to cover your buildout period, so you are not paying rent on a space you cannot yet use.

Free rent is one of the most common concessions, and for a healthcare tenant it serves a specific purpose: covering the weeks or months when the space is under construction and generating no revenue. How much you can get depends on lease length, your financial strength, and market conditions, but the buildout period is the floor, not the ceiling. Free rent directly lowers your effective rent, so it is often easier to win than a headline rate reduction, because the landlord preserves the number it reports. Confirm whether it applies to base rent only or also to CAM and other charges.

A flat annual escalation of around 3% is common, but the rate matters far more than it looks because it compounds.

A 3% annual escalation on a $30 rate reaches roughly $39 by year ten, a 30% increase built in from day one. A 4% escalation nearly doubles the rent over fifteen years. Some leases tie escalations to an index instead of a flat rate, which can run higher in inflationary periods. When reviewing a proposal, weigh the escalation rate as heavily as the starting rate: a low opening rate with a steep escalation can cost more over the term than a higher rate that stays flatter. Where you can, negotiate a lower rate or a cap.

When you sell a practice, the buyer almost always needs to take over your lease, so your assignment right is central to the sale.

Assignment transfers the lease entirely to the new owner, usually with landlord consent. The hidden risk is a recapture clause: instead of approving the transfer, it can let the landlord terminate the lease and take the space back, then offer the buyer a new lease at a higher market rate. That can complicate or even break the sale, and lower your sale price. This is why exit rights should be negotiated up front, not when you need them. Push for an assignment right that does not require unreasonable consent, and limit or remove any recapture clause at signing.

Only if your lease contains a relocation clause, which gives the landlord the right to move you to a different suite mid-lease, usually to accommodate a larger tenant.

For most businesses this is an inconvenience. For a medical or dental practice it can be serious: your patients know your location, your signage points to it, and your buildout was designed for that specific space. A forced move can mean lost patients, a second buildout cost, and disruption. Resist an unrestricted clause. If the landlord insists, require them to pay all moving and re-buildout costs, guarantee genuinely comparable space, give long advance notice, and cover new signage. Many practices negotiate it out for the early years or the whole term.

The base year is the first year of the lease, whose operating-expense level sets the baseline the landlord agrees to cover.

In every year after, you pay your proportional share of the amount by which expenses rise above that base-year level, while the landlord continues to cover the base. This is common in modified gross and full-service leases. The trap is an artificially low base year: if a landlord sets it in a year with unusually low expenses, your share of increases starts sooner and runs higher. Confirm the base year reflects a normal, fully-assessed year, understand which expense categories are included, and negotiate a cap on how fast your share can grow.

Effective rent is the true average rent you pay over the full term, after concessions like free rent and tenant improvement allowances and after escalations are counted.

To calculate it, add up the base rent for every year of the term (applying the escalation schedule), subtract the value of any free rent and the TI allowance, then divide by the number of years. For the most accurate comparison, discount those figures to present value. Effective rent matters because the headline rate hides both concessions and future increases: a higher quoted rate with strong concessions can have a lower effective rent than a low flat rate. It is the only number that compares two proposals honestly.

Ask for enough to cover most of your buildout, and benchmark against comparable medical deals rather than a standard office number.

Medical and dental buildouts are far more expensive than plain office space, commonly $150 to $350 per square foot in 2026, because of plumbing, electrical capacity, and specialized rooms. Landlord allowances vary with lease length, your financial strength, and shell condition, and a standard office figure will fall well short of a medical fit-out. Longer terms and stronger tenants unlock larger allowances. Get one or two preliminary construction bids before you negotiate, so you know your real number, and settle the allowance at the letter of intent stage where your leverage is highest.

Not necessarily, and this is the single most common mistake tenants make: comparing two spaces by base rent alone.

A $28 per square foot NNN lease adds your share of taxes, insurance, and maintenance on top, often $8 to $12 per square foot, bringing the real cost to $36 to $40. A $36 full-service (gross) lease bundles those costs into one fixed number the landlord absorbs. On the same space, the two structures can be tens of thousands of dollars apart in what you actually pay. The only honest comparison is total occupancy cost over the full term, not the headline rate. Build each offer out to its all-in annual figure before deciding.

In a triple net (NNN) lease, the pass-through charges commonly add $8 to $12 per square foot on top of base rent, and can run 40 to 60% of the quoted base rate.

That means a space quoted at $24 per square foot NNN is really closer to $32 to $36 all-in once you add your pro-rata share of property taxes, building insurance, and common area maintenance. The exact figure depends on the building and the town, and it changes each year through the CAM reconciliation. Because two buildings can quote the same base rate but carry very different pass-throughs, always ask for the current NNN estimate, a history of operating expenses, an audit right, and a cap on annual increases before comparing spaces.

If your landlord defaults on their mortgage and the lender forecloses, your lease can be extinguished — potentially forcing your practice out of a space you spent heavily to build out.

The protection against this is an SNDA (Subordination, Non-Disturbance and Attornment agreement). Its critical component is the non-disturbance clause, in which the lender agrees that as long as you are not in default, you may remain in your space under your existing lease even after a foreclosure. For a practice with an expensive buildout and a location-bound patient base, this is essential protection. It should be requested at lease signing, especially for long-term or build-to-suit space — it is far harder to obtain after the fact and worthless once a foreclosure is already underway.

Getting out of a commercial lease early depends heavily on the exit rights you negotiated when you signed.

The main options are subleasing (renting your space to another tenant while you remain on the hook), assignment (transferring the lease entirely to a new tenant, often when selling your practice), and negotiating an early termination or buyout with the landlord. Each usually requires landlord consent, and the terms of that consent are set by your lease. This is why exit flexibility should be negotiated up front, not when you need it — an assignment right that does not require unreasonable landlord consent protects the value of your practice if you sell. A holdover clause also matters if a transition runs late, since it governs what you pay if you stay past the lease term.

Zoning laws determine what a property can legally be used for, and a clinical or medical use is not automatically permitted everywhere.

A former retail storefront or an industrial flex space may require a special use permit or a zoning variance before a practice can operate there — and approval takes time and is not guaranteed. Zoning also governs practical requirements that affect medical uses directly, such as parking ratios (healthcare uses often need more parking than the previous tenant), signage, occupancy limits, and accessibility. Because municipalities classify uses differently, confirming the classification for your specific service at your specific address is essential before you commit. The safest approach is to verify zoning before signing the letter of intent and to make the lease contingent on obtaining any required approval.

A personal guaranty makes you personally responsible for the lease, meaning the landlord can pursue your personal assets — home, savings, investments — if the practice defaults.

Landlords often require one, especially from newer or single-owner practices, and the exposure can far exceed the value of the business. You rarely have to accept an unlimited guaranty, though. A "good guy" guaranty caps your liability to the period before you properly vacate the space. A burn-off provision releases the guaranty after a track record of on-time payments. A capped guaranty limits liability to a fixed amount. Negotiating the scope and duration of a personal guaranty is as important as negotiating rent — it defines how much personal risk the whole decision carries.

Without an exclusivity clause, nothing stops your landlord from leasing nearby space to a direct competitor — even after you have built your patient base.

An exclusivity clause is lease language in which the landlord agrees not to lease other space in the property, or the development, to competing uses. For practices with expensive buildouts and loyal, location-bound patients — dental, med spa, physical therapy — it is one of the most valuable clauses in the lease. To be effective, it must define the protected services specifically rather than by vague business label, address existing-tenant carve-outs, and include real remedies such as rent reduction or termination if the landlord violates it. Exclusivity is negotiated at the letter of intent stage, while you still have leverage.

An SBA 504 loan is a U.S. Small Business Administration program that provides long-term, fixed-rate financing for owner-occupied commercial real estate.

Its biggest advantage is the down payment: typically around 10% of the project cost, compared with 20–25% for a conventional commercial loan. On a $2,000,000 building, that can be the difference between roughly $200,000 and $400,000 in cash at closing — capital a practice can keep in the business instead. The program requires your business to occupy at least 51% of the building, which fits the owner-occupied model and even allows you to lease out the remaining space. The SBA portion carries a long fixed rate, protecting against interest rate swings. There are fees and early prepayment penalties to weigh, so the right comparison is total cost over how long you plan to hold the building.

Commercial rent is calculated on rentable square footage, not the usable space you actually occupy.

Rentable square footage adds a proportional share of the building's common areas — lobbies, corridors, shared restrooms — to your usable area. The percentage added is called the load factor, and it typically ranges from about 10% to 20%. This means a 2,000 usable square foot suite might be billed as 2,300 rentable square feet. Because two buildings can quote the same per-square-foot rate but carry very different load factors, comparing rents without knowing each one is misleading — a lower rate on a higher load factor can cost more overall. Always ask for both the usable and rentable figures, and the load factor between them, before comparing spaces.

A triple net (NNN) lease means you pay base rent plus your proportional share of the building's operating costs — property taxes, insurance, and common area maintenance, known as CAM charges.

CAM covers the upkeep of shared spaces like lobbies, hallways, parking, and restrooms. Because these charges are added on top of base rent, the advertised rate never reflects your true occupancy cost. Each year, the landlord reconciles estimated CAM payments against actual expenses, which can result in an additional bill or a credit. Tenants should always ask for a history of operating expenses, confirm the right to audit the reconciliation, and negotiate a cap on annual increases. Understanding CAM before signing prevents the most common cost surprise in commercial leasing.

A tenant improvement allowance (TI) is a sum the landlord provides to help build out or renovate your leased space, usually expressed as a dollar amount per square foot.

For healthcare and dental tenants, the TI is one of the most valuable and negotiable parts of a lease, because medical buildouts — plumbing, electrical capacity, specialized rooms — are far more expensive than standard office space. How much you can negotiate depends on the length of the lease, the strength of your practice, and the condition of the space. Longer terms and stronger tenants typically unlock larger allowances. The key is to benchmark against comparable medical deals in your submarket rather than accepting a standard office figure, and to negotiate it at the letter of intent stage when your leverage is highest.

For multi-location operators, West Loop should be assessed as part of a long-term portfolio strategy. Higher occupancy costs must be justified by unit economics, brand positioning, and demand without creating cannibalization across locations.

Expansion decisions should account for lease flexibility, scalability, buildout ROI, and the ability to adapt as the portfolio evolves. A strategic approach ensures West Loop strengthens the overall footprint rather than becoming a high-cost constraint.

In a landlord-driven market like West Loop, lease terms are typically structured to favor ownership. Tenant representation ensures operators are not negotiating alone against optimized landlord positions.

We advocate exclusively for tenants—negotiating rent, concessions, renewal options, and exit flexibility—while aligning the lease with the operator’s operational and financial goals. This reduces exposure to unfavorable escalations, restrictive clauses, and long-term occupancy risk.

The advisory approach is tailored to each stage of practice growth.

Our focus is on long-term practice stability, not just securing space so, yes.

Buildout costs are significantly higher, and relocation risk is greater, which makes lease structure and site selection far more critical than in standard office transactions.

Early involvement allows us to evaluate zoning, infrastructure requirements, lease risk, and long-term flexibility—before decisions become costly or irreversible.

Dental and healthcare practices can succeed in West Loop when the location supports patient access, clinical infrastructure, and long-term operational needs. The area’s demographics and density are favorable, but not every available space is suitable for medical use.

Practices must consider plumbing, power capacity, ceiling heights, parking access, and compliance requirements before committing. Lease terms must also allow flexibility around buildout timelines, renewals, and potential expansion or exit scenarios.

We do not represent landlords, list properties, or earn commissions from space owners. This ensures our advice is conflict-free and fully aligned with the dentist’s operational and financial interests.

We negotiate terms, economics, and key protections with a tenant-first focus—covering rent structure, concessions, TI allowances, renewal options, exit flexibility, and risk exposure. Our role is to ensure the lease supports your long-term operational and financial goals, not just getting a deal done.

This ensures our recommendations are unbiased and tenant-focused.

When leasing space in Lombard, tenants should confirm that zoning and permitted use align with their specific business model, particularly for healthcare, dental, or regulated services. Parking availability, ADA access, and building infrastructure can significantly impact buildout costs and operational efficiency.

Lease terms should also be reviewed carefully, with attention to renewal options, expansion rights, and exit flexibility. These factors often determine whether a location can support future growth without unnecessary risk.

Lombard is positioned within a dense residential market with consistent demand for healthcare and everyday services. The area benefits from flexible zoning, established medical corridors, and convenient access to major roadways serving the western suburbs.

For healthcare and service-based operators, Lombard often delivers a balance between visibility, accessibility, and more manageable lease economics compared to urban core locations, while still supporting long-term patient and customer retention.

Naperville combines strong household income, family-oriented density, and established commercial corridors.

Tenants benefit from long-term stability but must plan carefully around higher rents and competitive leasing conditions.

West Loop is one of Chicago’s most competitive submarkets, driven by dense daytime population, strong foot traffic, and proximity to transit. These factors make it attractive for service-based businesses and healthcare operators seeking visibility and long-term demand.

However, the same dynamics create higher lease rates, limited availability, and complex zoning considerations. Without a clear location strategy, operators may face misaligned space, excessive buildout costs, or long-term lease risk that limits flexibility.

Our advice is independent, conflict-free, and aligned solely with your business objectives, risk tolerance, and long-term interests.

Confirm the fundamentals before you sign. In Deerfield, the decision turns on corridor visibility, parking, and the balance of corporate and residential draw. Verify zoning and permitted use for a medical or service use, check real usable parking, and compare total occupancy cost across options, not just base rent. We run these checks as go or no-go questions early.

Yes, for the right practice. Deerfield is a strong North suburban market with affluent demographics, a corporate presence, and access via the Edens and Tri-State. That makes it a reliable market for medical, dental, and service operators, provided the specific corridor and space fit your patient base. We help you confirm that fit before you commit.

Yes. We represent tenants and owner-occupiers only, never landlords. In Highland Park and across the Chicago area, that means no conflict of interest: our advice on space, lease terms, and timing is built entirely around your side of the deal.

Confirm the fundamentals before you sign. In Highland Park, the decision turns on location fit, presentation, and limited quality inventory. Verify zoning and permitted use for a medical or service use, check real usable parking, and compare total occupancy cost across options, not just base rent. We run these checks as go or no-go questions early.

Yes, for the right practice. Highland Park is an affluent North Shore market with premium demographics and strong demand for medical and professional space. That makes it a reliable market for medical, dental, and service operators, provided the specific corridor and space fit your patient base. We help you confirm that fit before you commit.

Yes. We represent tenants and owner-occupiers only, never landlords. In Skokie and across the Chicago area, that means no conflict of interest: our advice on space, lease terms, and timing is built entirely around your side of the deal.

Confirm the fundamentals before you sign. In Skokie, the decision turns on corridor fit, co-tenancy near hospitals, and parking. Verify zoning and permitted use for a medical or service use, check real usable parking, and compare total occupancy cost across options, not just base rent. We run these checks as go or no-go questions early.

Yes, for the right practice. Skokie is a dense North suburban market with strong medical corridors and proximity to major hospital systems and Old Orchard. That makes it a reliable market for medical, dental, and service operators, provided the specific corridor and space fit your patient base. We help you confirm that fit before you commit.

Yes. We represent tenants and owner-occupiers only, never landlords. In Arlington Heights and across the Chicago area, that means no conflict of interest: our advice on space, lease terms, and timing is built entirely around your side of the deal.

Confirm the fundamentals before you sign. In Arlington Heights, the decision turns on corridor choice, co-tenancy, and competition for quality space. Verify zoning and permitted use for a medical or service use, check real usable parking, and compare total occupancy cost across options, not just base rent. We run these checks as go or no-go questions early.

Yes, for the right practice. Arlington Heights is an established Northwest suburban market with deep healthcare demand, strong demographics, and defined commercial corridors. That makes it a reliable market for medical, dental, and service operators, provided the specific corridor and space fit your patient base. We help you confirm that fit before you commit.

Yes. We represent tenants and owner-occupiers only, never landlords. In Itasca and across the Chicago area, that means no conflict of interest: our advice on space, lease terms, and timing is built entirely around your side of the deal.

Confirm the fundamentals before you sign. In Itasca, the decision turns on regional access, parking, and the surrounding tenant mix. Verify zoning and permitted use for a medical or service use, check real usable parking, and compare total occupancy cost across options, not just base rent. We run these checks as go or no-go questions early.

Yes, for the right practice. Itasca is a well-connected DuPage County village minutes from O'Hare with strong highway access via I-290 and I-355. That makes it a reliable market for medical, dental, and service operators, provided the specific corridor and space fit your patient base. We help you confirm that fit before you commit.

Yes. We represent tenants and owner-occupiers only, never landlords. In Mount Prospect and across the Chicago area, that means no conflict of interest: our advice on space, lease terms, and timing is built entirely around your side of the deal.

Confirm the fundamentals before you sign. In Mount Prospect, the decision turns on visibility, parking, and proximity to the residential base. Verify zoning and permitted use for a medical or service use, check real usable parking, and compare total occupancy cost across options, not just base rent. We run these checks as go or no-go questions early.

Yes, for the right practice. Mount Prospect is a Northwest suburban market with strong daytime population, O'Hare access, and corridors along Rand Road, Golf Road, and Elmhurst Road. That makes it a reliable market for medical, dental, and service operators, provided the specific corridor and space fit your patient base. We help you confirm that fit before you commit.

Yes. We represent tenants and owner-occupiers only, never landlords. In Deerfield and across the Chicago area, that means no conflict of interest: our advice on space, lease terms, and timing is built entirely around your side of the deal.

Anything above the allowance comes out of your pocket, so the allowance is worth negotiating hard.

The tenant improvement allowance rarely covers a full healthcare build-out, and change orders push costs higher. Lock your scope and equipment list before construction, keep a contingency of ten to fifteen percent, and negotiate both the allowance and how it is paid out before you sign.

A landlord can slow your project down, which is why the lease should protect you.

Delays happen when a landlord is slow to approve plans, delivers the space late, or drags out their portion of the work. A well-drafted lease ties your commencement date and rent obligations to the landlord actually delivering on time, so a landlord-caused delay does not become your cost.

A certificate of occupancy is the city confirming your finished space is safe and built to code.

After your build-out, inspectors check the building, fire, plumbing, electrical, and accessibility work. Once it all passes, the certificate is issued, and only then can you legally occupy the space and open. It is the last gate before you see patients, so build its timing into your plans.

Often four to five spaces per 1,000 square feet in the suburbs, more than a standard office.

Patients come and go all day, so medical and clinic uses carry higher parking minimums. The exact ratio is set by the local municipality, and Chicago has relaxed many minimums near transit. Confirm both the zoning requirement and the real usable parking before you sign.

Medical and dental offices are public accommodations and must meet the 2010 ADA Standards.

That means an accessible route from parking through the space, an accessible entrance, restroom, exam or treatment room, reception counter, and the right number of accessible parking spaces. Altering a space can also trigger required upgrades to shared parts of the building, especially in older properties.

For 2026, budget roughly 150 to 300 dollars per square foot in the Chicago area.

Dental, imaging, and surgical space tends to land at the higher end because of specialty plumbing, extra electrical, and dedicated HVAC. The condition the space is delivered in and the existing building systems are the biggest swings, so get a real contractor estimate on the specific space.

Both are unfinished, but a vanilla box is delivered further along than a warm shell.

A warm shell usually has HVAC, electrical service, and often restrooms, but a bare interior. A vanilla box adds finished walls, a ceiling, and lighting on top of that. Neither has a fixed industry definition, so always get the exact delivery condition in writing.

Yes, and the permit is what lets construction start.

Your architect prepares a permit set, the city reviews it, and work cannot begin until the permit is issued. A complete, accurate set clears review faster. At the end, you need a certificate of occupancy before you can legally open your doors.

Plan for roughly four to eight months from the start of design to the day you see patients.

That window covers four stages: design and space planning, permitting, construction, and final inspections. A larger practice, or one with imaging or surgical space, can run longer, and Chicago permitting usually takes more time than the suburbs.

It depends entirely on what you negotiate, which is why you settle it before you sign.

Three separate things decide who pays: the work letter splits landlord work from tenant work, the delivery condition sets what the landlord hands you, and the tenant improvement allowance is money the landlord contributes. Blur them together and you can end up covering costs you assumed were the landlord's.

The decision to buy or lease is a financial comparison, not an ideology — and it should follow the location decision, never lead it.

Buying makes sense when the location is right for the long term, the price is supported by real income and comparable sales, and the capital is not needed for higher-return uses like opening additional locations. As an owner-occupant, the rent you would pay instead builds your own equity, and you gain control over the space. Leasing makes sense when flexibility, growth capital, or location uncertainty dominate. The right answer depends on evaluating the building's net operating income, the cap rate implied by the price, your financing, and what else that down payment could do for your practice. A buyer's advisor helps run that comparison honestly before you commit.

Healthcare real estate differs significantly from traditional commercial real estate because medical practices have unique operational, regulatory, and patient experience requirements.

A healthcare-focused commercial real estate advisor understands factors such as specialized medical build-outs, patient accessibility, parking requirements, ADA compliance, practice workflow, referral patterns, and long-term growth planning. This industry expertise helps healthcare professionals identify properties that better support both clinical operations and financial goals.

Whether you’re buying, leasing, or selling a medical office building, working with an advisor who specializes in healthcare real estate can reduce risk, streamline negotiations, and improve long-term decision-making.

Yes. Purchasing a medical office building isn’t limited to long-established practices.

Many physicians, dentists, and other healthcare providers successfully purchase property early in their practice’s growth by securing appropriate financing and demonstrating a solid business plan. Lenders typically evaluate factors such as professional experience, projected revenue, available capital, credit history, and overall financial strength.

Buying early can provide long-term financial advantages, including building equity and avoiding future rent increases, although every situation should be evaluated individually.

Purchasing a medical office building requires evaluating much more than the purchase price.

Healthcare professionals should consider the property’s location, patient accessibility, parking availability, zoning requirements, visibility, building condition, and future expansion potential. Financial factors such as financing terms, operating expenses, maintenance costs, and projected long-term ownership costs should also be carefully reviewed.

A comprehensive due diligence process helps identify potential risks and ensures the property aligns with both your current operational needs and future business objectives.

Most medical office building acquisitions are completed within 90 to 180 days, although the timeline can vary depending on the complexity of the transaction.

The process typically begins with identifying suitable properties, followed by financing approval, negotiating the purchase agreement, completing inspections, conducting due diligence, and finalizing legal documentation before closing.

Working with experienced healthcare real estate professionals, lenders, and legal advisors can help keep the transaction moving efficiently while minimizing delays.

Healthcare professionals may qualify for several financing solutions when purchasing a medical office building, including conventional commercial mortgages, SBA loans, and specialized healthcare lending programs.

The financing structure available to you will depend on factors such as your credit profile, business history, down payment, cash flow, and the characteristics of the property being purchased.

Working with experienced lenders and healthcare-focused commercial real estate advisors can help simplify the financing process and identify the most appropriate solution for your practice.

Purchasing a medical office building allows you to build equity, gain greater control over your space, and potentially benefit from long-term property appreciation. Leasing, on the other hand, typically requires a lower upfront investment while offering greater flexibility to relocate or expand.

The right decision depends on factors such as available capital, financing options, expected growth, operational needs, and your long-term business strategy.

An owner-occupied medical office building is a commercial property where a healthcare practice owns and occupies a significant portion of the building instead of leasing space from a third-party landlord.

This ownership model allows physicians, dentists, and other healthcare professionals to build long-term equity while maintaining greater control over their facility. Owners also have the flexibility to customize their space, reduce long-term occupancy uncertainty, and potentially benefit from property appreciation over time.

Whether ownership is the right strategy depends on your financial goals, available capital, financing options, and long-term practice plans.

Early engagement maximizes leverage, options, and long-term alignment.

The earlier we’re involved, the more leverage and flexibility you have—whether that’s evaluating markets, shaping lease terms, or avoiding constraints that are hard to unwind later.

That said, we can add value at any stage: renewals, relocations, expansions, or even when you’re already deep in negotiations. Early involvement just means better outcomes.

While we support negotiations and execution, our role is to guide strategy, evaluate risk, and protect tenant interests — not to push transactions