Organization
MOUNT SINAI COMMUNITY FOUNDATION DBA SINAI MEDICAL GROUP
Active
Parent organization
MOUNT SINAI COMMUNITY FOUNDATION DBA SINAI MEDICAL GROUP
Other names
SMG OB on Central
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOUNT SINAI COMMUNITY FOUNDATION DBA SINAI MEDICAL GROUP
Authorized official
DEBORAH CAPUTO (CREDENTIALING MANAGER)
(773) 257-2905
Entity
Organization
Contact information
Practice address
645 S CENTRAL AVE FL 6, CHICAGO, IL 60644-5059
(773) 854-5328
(773) 854-5587
Mailing address
1501 S CALIFORNIA AVE NR 7-130, CHICAGO, IL 60608
(773) 257-2905
(773) 257-1788
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
—
—
Other
Enumeration date
08/02/2019
Last updated
08/02/2019
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