Provider Demographics
NPI:1649694340
Name:MOUNT SINAI HOSPITAL
Entity type:Organization
Organization Name:MOUNT SINAI HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN AND RESIDENCY DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AZIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:IHAB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-257-6045
Mailing Address - Street 1:1930 N HARLEM AVE
Mailing Address - Street 2:#405
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60707-3742
Mailing Address - Country:US
Mailing Address - Phone:215-292-7688
Mailing Address - Fax:
Practice Address - Street 1:1930 N HARLEM AVE APT 405
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:IL
Practice Address - Zip Code:60707-3758
Practice Address - Country:US
Practice Address - Phone:215-292-7688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-16
Last Update Date:2014-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125060717207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty