Provider Demographics
NPI:1871927053
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:
Authorized Official - First Name:IHAB
Authorized Official - Middle Name:
Authorized Official - Last Name:AZIZ
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 1:1501 S CALIFORNIA AVE
Practice Address - Street 2:SUITE L1026
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-1732
Practice Address - Country:US
Practice Address - Phone:773-257-6097
Practice Address - Fax:773-257-6045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-24
Last Update Date:2013-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125060717282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital