MOUNT SINAI COMMUNITY FOUNDATION (NPI# 1780094508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780094508 |
| Entity Type | Organization |
| Organization Name | MOUNT SINAI COMMUNITY FOUNDATION |
| Other Organization Name | SMG WASHINGTON |
| Practice Address |
3857 W Washington Blvd Chicago IL 60624-2342 |
| Mailing Address |
26460 Network Pl Chicago IL 60673-1264 |
| Practice Telephone | 7735334850 |
| Mailing Telephone | 7087862900 |
| Enumeration Date | 2014-05-01 |
| Last Update Date | 2014-05-01 |
| Authorized Official Name | JOHN VAZQUEZ (CMO) |
| Authorized Official Telephone | 7732576850 |
| Is Organization Subpart | Y |
| Parent Organization Name | MOUNT SINAI COMMUNITY FOUNDATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| SMG Washington | 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 |
| 1851454698 | Mount Sinai Community Foundation | Internal Medicine | 2218 S. Michigan Ave, Smg Lakeside Medical Center, Chicago, IL 60616-2189 | 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 |
| Street Address |
3857 W WASHINGTON BLVD |
| City | CHICAGO |
| State | IL |
| Zip Code | 60624-2342 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588694343 | Percy Conrad May II | Family Medicine | 3857 W Washington Blvd, Chicago, IL 60624-2342 | 2006-07-04 |
| 1164880498 | Rosalind Seals | Nurse Practitioner | 3857 W Washington Blvd, Chicago, IL 60624-2342 | 2016-02-01 |
| 1881063949 | May Medical Center | Clinic/Center | 3857 W Washington Blvd, Chicago, IL 60624-2342 | 2015-09-18 |
| 1497068977 | Promed Pharmacy Inc | Pharmacy | 3857 W Washington Blvd, Chicago, IL 60624-2342 | 2010-07-26 |
| 1629209507 | Gabby Drugs Inc | Pharmacy | 3857 W Washington Blvd, Chicago, IL 60624-2342 | 2009-07-27 |
| 1306076757 | Gabby Drug Inc | Pharmacy | 3857 W Washington Blvd, Chicago, IL 60624-2342 | 2009-07-20 |
| 1679744197 | Harshad M. Kamdar D.d.s. Ltd | Dentist | 3857 W Washington Blvd, Chicago, IL 60624-2342 | 2008-03-13 |
| 1649463175 | Conrad May M.d. Ltd | Health Maintenance Organization | 3857 W Washington Blvd, Chicago, IL 60624-2342 | 2007-08-17 |
| 1962535484 | Christopher Conrad May | Family Medicine | 3857 W Washington Blvd, Chicago, IL 60624-2342 | 2007-03-13 |
| 1932201431 | Harshad M Kamdar | Dentist | 3857 W Washington Blvd, Chicago, IL 60624-2342 | 2006-09-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669071932 | Euginia Ivanova | Counselor | 3410 W. Roosevelt Rd, Chicago, IL 60624 | 2020-10-19 |
| 1629619572 | Denise R Bean | Technician | 3322 West Polk St, Chicago, IL 60624 | 2019-10-02 |
| 1033693742 | Ahmed Hussain Memon | Nurse Practitioner | 3800 West Madison, Chicago, IL 60624 | 2018-09-18 |
| 1487104006 | Jeffrey Blythe | Social Worker | 3605 W. Fillmore Street, Ucan, Chicago, IL 60624 | 2016-10-06 |
| 1366992216 | Brian Macwilliams | Social Worker | 3605 W. Fillmore St, Chicago, IL 60624 | 2016-10-04 |
| 1982151510 | Darryl Lamont Clayton | Counselor | 3605 W. Fillmore, Chicago, IL 60624 | 2016-09-01 |
| 1821487646 | Total Enrichment Services Inc. | Counselor | 3335 W Washington Blvd, Chicago, IL 60624 | 2015-01-16 |
| 1295038818 | Raad N Rashan M D S C | Internal Medicine | 3743 W Chicago Ave, Chicago, IL 60624 | 2010-12-21 |
| 1194044453 | Theresa Roberts | Speech-Language Pathologist | 3240 W. Franklin Blvd, Chicago, IL 60624 | 2010-05-26 |
| 1154570208 | Ht Outpatient Pharmacy | Pharmacy | 3435 W Vanburen St, Chicago, IL 60624 | 2008-09-13 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922606193 | Thatiana Carolina Schulze Goni | Internal Medicine | 5924 N Lincoln Ave Apt 205, Chicago, IL 60659-3736 | 2020-10-11 |
| 1750995742 | Eva Bartaula | Internal Medicine | 1500 S Fairfield Ave # 3, Chicago, IL 60608-1782 | 2020-09-07 |
| 1750994513 | Ranjit Babu Jasaraj | Internal Medicine | 1500 S Fairfield Ave # F-914, Chicago, IL 60608-1782 | 2020-08-30 |
| 1871106005 | Vijay Ketan Reddy | Internal Medicine | 1500 S Fairfield Ave Dept Roomf914, Chicago, IL 60608-1782 | 2020-08-27 |
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1871119172 | Irina Komissarova | Internal Medicine | 916 S Oakley Blvd, Chicago, IL 60612-4230 | 2020-06-22 |
| 1336760719 | Arslan Zahid | Internal Medicine | 5847 S Maryland Ave, Chicago, IL 60637-1463 | 2020-04-27 |
| 1104447572 | Nirmal Desai | Internal Medicine | 5841 S Maryland Ave., M/c 7082, Chicago, IL 60637-1443 | 2020-04-27 |
| 1467072447 | Justin Edmond Sipiora | Internal Medicine | 5841 S. Maryland Ave Mc 7082, Chicago, IL 60637-1443 | 2020-04-20 |
| 1003449612 | Eoht LLC | Internal Medicine | 1718 W North Shore Ave Apt 11, Chicago, IL 60626-4030 | 2020-02-21 |
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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.