Organization · Type 2 NPI

Mount Sinai Community Foundation dba Sinai Medical Group

Obstetrics Physician · Chicago, IL

NPI number 1104471622 Active

Practice location

645 S Central Ave Fl 6
Chicago, IL 60644-5059

Call (773) 854-5328 Map

Fax (773) 854-5587

Mailing address

1501 S California Ave Nr 7-130
Chicago, IL 60608

Specialties and licenses

Taxonomy	Code	License
Obstetrics Physician Primary	207VX0000X	None listed

Obstetrics Physician: A physician who specializes in diagnosis, treatment, and management of patients with obstetric conditions.

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NPI record

NPI: 1104471622
Entity type: Organization (Type 2)
Issued: Aug 2, 2019
Last updated: Aug 2, 2019
Status: Active
Subpart: Yes of Mount Sinai Community Foundation dba Sinai Medical Group

Other names

SMG Ob On Central · doing business as

Authorized official

Deborah Caputo
Credentialing Manager
(773) 257-2905

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104471622

Mount Sinai Community Foundation dba Sinai Medical Group's National Provider Identifier is 1104471622, issued on Aug 2, 2019. The primary taxonomy on file is Obstetrics Physician (207VX0000X), and the practice location is in Chicago, IL. The record was last updated on Aug 2, 2019.