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General NPI Number Information
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NPI Number | 1578363040
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Entity Type | Organization
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Legal Business Name | MOUNT SINAI COMMUNITY FOUNDATION DBA SINAI MEDICAL GROUP
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Dates
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Enumeration Date | 03/14/2025
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 1500 S FAIRFIELD AVE
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City | CHICAGO
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State | IL
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Zip | 60608-1782
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Country | US
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Telephone | 773-542-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 1501 S CALIFORNIA AVE
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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 | 773-542-2000
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Fax |
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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 | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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