# MOUNT SINAI FAMILY PRACTICE RESIDENCY PROGRAM OF CHICAGO

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093949729
- **Authorized official:** DR. MARIA R. CISNEROS MD (RESIDENT/PHYSICIAN)
- **Authorized official phone:** (773) 257-6097

## Contact information

- **Practice address:** 1500 S CALIFORNIA AVE, CHICAGO, IL 60608-1729
- **Practice address phone:** (773) 257-6097
- **Mailing address:** 1644 S CORA ST, DES PLAINES, IL 60018-2210
- **Mailing address phone:** (312) 860-1058

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 036117932 | IL | Yes |

## Other

- **Enumeration date:** 05/09/2009
- **Last updated:** 05/09/2009