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General NPI Number Information
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NPI Number | 1255288254
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Entity Type | Organization
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Legal Business Name | MOUNT SINAI MEDICAL CENTER
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Dates
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Enumeration Date | 03/11/2026
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Last Update Date | 03/11/2026
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Provider Practice Location Address
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Address Line | 2653 W OGDEN AVE FL 2
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City | CHICAGO
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State | IL
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Zip | 60608-1647
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Country | US
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Telephone | 773-257-6672
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Fax | 773-257-5330
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Provider Business Mailing Address
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Address Line | 1501 S CALIFORNIA AVE # 7-140
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City | CHICAGO
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State | IL
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Zip | 60608-1732
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Country | US
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Telephone | 773-257-2933
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Fax | 773-762-8834
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | CHRISTOPHER STEPHENS
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Credential |
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Telephone | 773-257-2933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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