Basic Information
| Provider Information | |||||||||
| NPI: | 1871927053 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MOUNT SINAI HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1930 N HARLEM AVE | ||||||||
| Address2: | #405 | ||||||||
| City: | ELMWOOD PARK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 607073742 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2152927688 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1501 S CALIFORNIA AVE | ||||||||
| Address2: | SUITE L1026 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606081732 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7732576097 | ||||||||
| FaxNumber: | 7732576045 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2013 | ||||||||
| LastUpdateDate: | 08/24/2013 | ||||||||
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| AuthorizedOfficialLastName: | AZIZ | ||||||||
| AuthorizedOfficialFirstName: | IHAB | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHAIRMAN AND RESIDENCY DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7732576045 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 125060717 | IL | Y | Hospitals | General Acute Care Hospital |
No ID Information.