Organization Active NPI

Professsional Health Associates LTD.

  • Psychiatry Physician
  • Palos Heights, IL
National Provider Identifier
1114020757
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PROFESSSIONAL HEALTH ASSOCIATES LTD.
Practice address
12255 S. 80TH Avenue
Suite 202
Palos Heights, IL 60463
Phone
(708) 923-7880
Fax
(708) 923-7888
NPI assigned
Sep 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mark Robert Sinibaldi, M.D.NPI 1376581413
Title
President
Phone
(708) 923-7880

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X IL Primary

Addresses

Primary practice location

12255 S. 80TH Avenue
Suite 202
Palos Heights, IL 60463

Mailing address

12255 S. 80TH Avenue
Suite 202
Palos Heights, IL 60463
Phone (708) 923-7880

Other identifiers 1

IdentifierTypeStateIssuer
0991516762OtherILBLUE CROSS BLUE SHEILD

National Provider Directory

National Provider Directory

Locations

200 N Hammes Ave
Ste 3
Joliet, IL 60435
Phone (815) 744-8253

12255 S 80th Ave
Ste 202
Palos Heights, IL 60463
Phone (708) 923-7878

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114020757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12255 S. 80TH AVENUE",
            "address_2": "SUITE 202",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "60463",
            "telephone_number": "708-923-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12255 S. 80TH AVENUE",
            "address_2": "SUITE 202",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "60463",
            "telephone_number": "708-923-7880",
            "fax_number": "708-923-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSSIONAL HEALTH ASSOCIATES LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SINIBALDI",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-923-7880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "0991516762",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.