Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Professional Health Sport, Inc

Organization General Practice Physician · NPI 1063632917

Professional Health Sport, Inc is a General Practice Physician 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
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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