# 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 Wentworth
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1679159529
- **Legal business name:** MOUNT SINAI COMMUNITY FOUNDATION
- **Authorized official:** DEBORAH CAPUTO (MANAGER)
- **Authorized official phone:** (773) 257-2905

## Contact information

- **Practice address:** 2323 S WENTWORTH AVE, CHICAGO, IL 60616-4615
- **Practice address phone:** (312) 567-2900
- **Practice address fax:** (312) 842-4967
- **Mailing address:** 26460 NETWORK PL, CHICAGO, IL 60673-1264
- **Mailing address phone:** (773) 257-2820
- **Mailing address fax:** (773) 762-8529

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/22/2021
- **Last updated:** 03/22/2021