Healthcare Provider Details

I. General information

NPI: 1538007331
Provider Name (Legal Business Name): SKYE HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29532 SOUTHFIELD RD STE 115
SOUTHFIELD MI
48076-2023
US

IV. Provider business mailing address

29532 SOUTHFIELD RD STE 115
SOUTHFIELD MI
48076-2023
US

V. Phone/Fax

Practice location:
  • Phone: 248-587-8267
  • Fax: 248-973-1345
Mailing address:
  • Phone: 248-587-8267
  • Fax: 248-973-1345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MARK IJLAL
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 248-587-8267