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NPI Code Detail

MEDICARE: MOUNT SINAI COMMUNITY FOUNDATION

MEDICARE: MOUNT SINAI COMMUNITY FOUNDATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician

General Provider Information

NPI Number : 1679975221
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOUNT SINAI COMMUNITY FOUNDATION
Provider Business Mailing Address
First Line : 26460 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1264
Country : US
Telephone Number : 708-786-2900
Fax Number :
Provider Business Practice Location Address
First Line : 3943 W 31ST ST
Second Line :
City : CHICAGO
State : IL
Zip : 60623-4936
Country : US
Telephone Number : 773-523-8773
Fax Number : 773-523-9259
Authorized Official
Title or Position : CMO
Name : JOHN VAZQUEZ
Credential :
Telephone Number : 773-257-6850
Provider Enumeration Date : 09/25/2014
Last Update Date : 09/25/2014

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Directions to “MOUNT SINAI COMMUNITY FOUNDATION ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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