Healthcare Provider Details

I. General information

NPI: 1669319695
Provider Name (Legal Business Name): MOUNT SINAI HOSPITAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S FAIRFIELD AVE
CHICAGO IL
60608-1782
US

IV. Provider business mailing address

1500 S FAIRFIELD AVE
CHICAGO IL
60608-1782
US

V. Phone/Fax

Practice location:
  • Phone: 773-257-2893
  • Fax:
Mailing address:
  • Phone: 773-542-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER STEPHENS
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 773-257-2933