Active NPI
Philip Friere Skiba, D.O.
- Sports Medicine (Family Medicine) Physician
- Park Ridge, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Family Medicine) Physician
- License
- 036.131290
- Practice address
- 1775 Ballard Rd
Park Ridge, IL 60068-1005 - Phone
- (847) 318-6020
- NPI assigned
- Apr 15, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Family Medicine) Physician | 207QS0010X | 25MB08012700 | NJ | |
| Sports Medicine (Family Medicine) Physician | 207QS0010X | 036.131290 | IL | Primary |
Addresses
Primary practice location
1775 Ballard Rd
Park Ridge, IL 60068-1005
Mailing address
29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pskiba204965@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Sports Medicine
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
601 Walnut St
Suite L50
Philadelphia, PA 19106-3305
Phone (215) 955-7190
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.131290 | IL | MD | Sports Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Jefferson University Physicians | Current | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Jefferson University Physicians | Past | Accepting new patients | |
| Hackensack Meridian Health Medical Group - Complex Care PC | Past | Accepting new patients |
Locations
214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160
135 N Arlington Heights Rd
Buffalo Grove, IL 60089
Phone (847) 215-8866
29373 Network Pl
Chicago, IL 60673
1775 Ballard Rd
Park Ridge, IL 60068
Phone (847) 318-6020
170 S Independence Mall W
Ste L50
Philadelphia, PA 19106
3 Crescent Dr
Fl 3
Philadelphia, PA 19112
Phone (215) 503-3321
1101 Market St
Fl 19
Philadelphia, PA 19107
Phone (215) 481-6836
925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Physician
- Philadelphia, PA
- NPI 1326093675
-
- Multi-Specialty Clinic/Center
- Oak Brook, IL
- NPI 1700824455
-
- Children's Hospital
- Oak Lawn, IL
- NPI 1508315516
-
- Internal Medicine Physician
- Red Bank, NJ
- NPI 1154379626
-
- Gastroenterology Physician
- Phila, PA
- NPI 1205898723
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Philadelphia, PA
- NPI 1366653818
-
- Rehabilitation Hospital
- Phila, PA
- NPI 1265410047
Inpatient rehabilitation facility
-
- Long Term Care Hospital
- Philadelphia, PA
- NPI 1427232818
Long-term care hospital
-
- General Acute Care Hospital
- Philadelphia, PA
- NPI 1215916002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662940800000",
"number": "1578737276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29373 NETWORK PL",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606731293",
"telephone_number": "847-390-5900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1775 BALLARD RD",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600681005",
"telephone_number": "847-318-6020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKIBA",
"first_name": "PHILIP",
"middle_name": "FRIERE",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-15",
"last_updated": "2022-09-12",
"certification_date": "2022-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "NJ",
"license": "25MB08012700",
"primary": false
},
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "IL",
"license": "036.131290",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "pskiba204965@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1775 Ballard Rd",
"city": "Park Ridge",
"state": "IL",
"country_code": "US",
"postal_code": "600681005",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "1775 Ballard Rd",
"city": "Park Ridge",
"state": "IL",
"country_code": "US",
"postal_code": "600681005",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Park Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.