Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Professional Health Sport, Inc

Organization General Practice Physician · NPI 1063632917

Professional Health Sport, Inc provides General Practice Physician services in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2007.

Licensed in
IL
In the registry since
2007
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6288 N Cicero Ave
Chicago, IL 60646-4918 Not confirmed with CMS for 19 years — call before visiting
Phone: (773) 205-1418
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X (IL)
Interventional Pain Medicine Physician Taxonomy 208VP0014X (IL)

Record details

NPI number1063632917
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Dehelean — President · (773) 205-1418
NPI enumeratedApril 25, 2007
Last updated in NPPESOctober 1, 2007
Mailing address6288 N Cicero Ave, Chicago, IL 60646-4918

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