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Organization
MOUNT SINAI HOSPITAL MEDICAL CENTER
Active
Organization
MOUNT SINAI HOSPITAL MEDICAL CENTER
Active
Other names
Pioneer House
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN C TEITELBAUM (EXECUTIVE VICE PRESIDENT/COO)
(773) 257-5332
Entity
Organization
Contact information
Practice address
812 S WESTERN AVE, CHICAGO, IL 60612-4140
(312) 666-6897
Mailing address
812 S WESTERN AVE, CHICAGO, IL 60612-4140
(312) 666-6897
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
0001644
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639470867
—
IL
05
—
1932496114
—
IL
Enumeration date
07/07/2011
Last updated
12/19/2016
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