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General NPI Number Information
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NPI Number | 1508026030
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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 | 06/09/2008
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Last Update Date | 06/09/2008
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Provider Practice Location Address
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Address Line | CALIFORNIA AT 15 TH STREET DEPARTMENT OF CARDIOLOGY
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City | CHICAGO
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State | IL
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Zip | 60608
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Country | US
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Telephone | 773-257-6452
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Fax |
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Provider Business Mailing Address
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Address Line | CALIFORNIA AT 15 TH STREET DEPARTMENT OF CARDIOLOGY
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City | CHICAGO
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State | IL
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Zip | 60608
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CARDIOLOGY FELLOW
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Name | EVYAN JAWAD
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Credential | MD
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Telephone | 773-257-6452
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 036099316
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License Number State | IL
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