Provider Demographics
NPI:1922797935
Name:MOUNT SINAI COMMUNITY FOUNDATION DBA SINAI MEDICAL GROUP
Entity Type:Organization
Organization Name:MOUNT SINAI COMMUNITY FOUNDATION DBA SINAI MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, SINAI MEDICAL GROUP
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER SPROWL
Authorized Official - Middle Name:
Authorized Official - Last Name:SPROWL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-257-4320
Mailing Address - Street 1:26460 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1264
Mailing Address - Country:US
Mailing Address - Phone:773-542-2000
Mailing Address - Fax:
Practice Address - Street 1:2701 W 68TH ST FL 6
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60629-1813
Practice Address - Country:US
Practice Address - Phone:773-884-8200
Practice Address - Fax:773-884-8225
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOUNT SINAI COMMUNITY FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty