# MOUNT SINAI COMMUNITY FOUNDATION DBA SINAI MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MOUNT SINAI COMMUNITY FOUNDATION
- **Other names:** SMG at SCI -Surgery
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1023451119
- **Legal business name:** MOUNT SINAI COMMUNITY FOUNDATION
- **Authorized official:** JOHN E VAZQUEZ MD (CMO)
- **Authorized official phone:** (773) 257-6850

## Contact information

- **Practice address:** 2653 W OGDEN AVE, 3RD FLOOR SUITE A, CHICAGO, IL 60608-1647
- **Practice address phone:** (773) 257-6701
- **Practice address fax:** (773) 257-6226
- **Mailing address:** 3537 PAYSPHERE CIR, CHICAGO, IL 60674-0035
- **Mailing address phone:** (708) 786-2900
- **Mailing address fax:** (708) 786-2992

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/09/2013
- **Last updated:** 04/09/2013