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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
1207R00000XInternal Medicine Physician036059684IL
2208000000XPediatrics Physician036046138IL
3207Q00000XFamily Medicine Physician036083208IL

General Provider Information

NPI Number : 1891859559
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOUNT SINAI COMMUNITY FOUNDATION
Provider Business Mailing Address
First Line : 3111 W ARMITAGE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-3818
Country : US
Telephone Number : 773-394-5260
Fax Number : 773-394-5271
Provider Business Practice Location Address
First Line : 5470 W MADISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60644-4031
Country : US
Telephone Number : 773-378-4100
Fax Number : 773-287-5923
Authorized Official
Title or Position : CMO
Name : JOHN E VAZQUEZ
Credential :
Telephone Number : 773-257-6850
Provider Enumeration Date : 12/20/2006
Last Update Date : 06/18/2013

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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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