MOUNT SINAI COMMUNITY FOUNDATION (NPI# 1851454698) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851454698 |
| Entity Type | Organization |
| Organization Name | MOUNT SINAI COMMUNITY FOUNDATION |
| Other Organization Name | SMG LAKESIDE MEDICAL CENTER |
| Practice Address |
2218 S. Michigan Ave Smg Lakeside Medical Center Chicago IL 60616-2189 |
| Mailing Address |
1501 S California Ave Chicago IL 60608-1732 |
| Practice Telephone | 3128422082 |
| Practice Fax Number | 3128422214 |
| Mailing Telephone | 7087862905 |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2013-05-28 |
| Authorized Official Name | JOHN E. VAZQUEZ (CMO) |
| Authorized Official Telephone | 7732576850 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 036059684 | IL | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 036046138 | IL | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 036103785 | IL | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| SMG Lakeside Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861024176 | Mount Sinai Community Foundation | Clinic/Center | 1414 S Fairfield, Chicago, IL 60608 | 2020-02-05 |
| 1609072313 | Mount Sinai Community Foundation | Psychiatric Hospital | 2040 W Washington Blvd, Chicago, IL 60612-2429 | 2007-06-21 |
| 1649318148 | Mount Sinai Community Foundation | Surgery | 2720 W. 15th, Chicago, IL 60608-1647 | 2007-02-05 |
| 1952449456 | Mount Sinai Community Foundation | Internal Medicine | 2901 W Touhy Ave, Chicago, IL 60645-2937 | 2007-02-05 |
| 1679611628 | Mount Sinai Community Foundation | Internal Medicine | 2720 W 15th, Chicago, IL 60608-1647 | 2007-02-02 |
| 1144383084 | Mount Sinai Community Foundation | Internal Medicine | 3111 W Armitage Ave, Chicago, IL 60647-3818 | 2006-12-19 |
| 1134164841 | Mount Sinai Community Foundation | Family Medicine | 1400 E. Golf Rd, Suite 118, Des Plaines, IL 60016 | 2006-06-17 |
| 1497374805 | Mount Sinai Community Foundation | Clinic/Center | 2653 W Ogden Ave, Chicago, IL 60608-1647 | 2020-04-15 |
| 1720538572 | Mount Sinai Community Foundation | Internal Medicine | 4318 S State St, Chicago, IL 60609-3701 | 2016-10-05 |
| 1659821403 | Mount Sinai Community Foundation | Psychiatry & Neurology | 2601 W Marquette Rd, Chicago, IL 60629-1817 | 2016-10-05 |
| Street Address |
2218 S. MICHIGAN AVE SMG LAKESIDE MEDICAL CENTER |
| City | CHICAGO |
| State | IL |
| Zip Code | 60616-2189 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558993758 | King Dental, PC | Clinic/Center | 3425 S King Dr, Chicago, IL 60616 | 2020-02-06 |
| 1386286144 | Anais Karel Jackson-gonzalez | Acupuncturist | 2018 S. Michigan Ave., Chicago, IL 60616 | 2019-10-14 |
| 1215499777 | Mashaal F Ikram | Student in an Organized Health Care Education/Training Program | Mercy Hospital and Medical Center, 2525 South Michigan Avenue, Chicago, IL 60616 | 2019-04-03 |
| 1891254223 | Towayn Heaven | Acupuncturist | 2018 S Michigan Ave, Chicago, IL 60616 | 2019-03-15 |
| 1689131518 | Abhishek Santos Pandya | Internal Medicine | 2525 S Michigan Ave., Mercy Hospital and Medical Center, Chicago, IL 60616 | 2019-02-27 |
| 1144703992 | Katelyn Michelle St Martin | Physician Assistant | 2850 S Michigan Ave Ste 100, Chicago, IL 60616 | 2018-09-07 |
| 1902383953 | Healing Empowering & Learning Professionals LLC | Clinic/Center | 2930 S Michigan Ave Ste 100, Chicago, IL 60616 | 2018-07-23 |
| 1437644812 | Puja Bhagwakar | Dentist | 1620 S Michigan Ave Unit 704, Chicago, IL 60616 | 2018-06-27 |
| 1821589110 | David Alexander Sousa Frias | Internal Medicine | 2525 Michigan Ave, Mercy Hospital At Medical Center, Chicago, IL 60616 | 2018-05-23 |
| 1508394933 | Awad Eyecare Sc | Optometrist | 1845 S Michigan Ave Unit 1803, Chicago, IL 60616 | 2017-05-30 |
| Find all providers in zip 60616 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053911495 | Moataz Barkat | Family Medicine | 3315 W 66th Pl, Chicago, IL 60629-3427 | 2020-10-26 |
| 1558976589 | Jasmine Ashley Fowler | Family Medicine | 2416 N Lotus Ave, Chicago, IL 60639-1435 | 2020-09-15 |
| 1720699176 | Healing Hands Resource Center Streator | Family Medicine | 2128 S Central Park Ave, Chicago, IL 60623-3113 | 2020-08-10 |
| 1285251892 | Soe Lwin Oo | Family Medicine | 1625 E 75th St # 1, Chicago, IL 60649-3603 | 2020-06-30 |
| 1124645700 | Timothy Alan Williams Jr. | Family Medicine | 1625 E 75th St Fl 1, Chicago, IL 60649-3603 | 2020-06-30 |
| 1194340026 | Kaysha Lynne Ribao | Family Medicine | 2116 S Springfield Ave, Chicago, IL 60623-2465 | 2020-06-16 |
| 1932724341 | Toni Kurian | Family Medicine | 1550 S Indiana Ave Apt 407, Chicago, IL 60605-4822 | 2020-06-11 |
| 1528689486 | Thurman J Robertson | Family Medicine | 1950 W. Polk Street, 7th Floor, Chicago, IL 60612-3714 | 2020-05-01 |
| 1629697297 | Lyndsey Danielle Johnson | Family Medicine | 2804 W Walton St, Chicago, IL 60622-4450 | 2020-04-13 |
| 1730708884 | Iruoma Genevieve Nwangwu | Family Medicine | 1950 W Polk Street, Chicago, IL 60612-3714 | 2020-04-09 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.