NPIMap

Organization Active NPI

Mount Sinai Community Foundation

Doing business as SMG West Lawn

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1114381977
Registry record updated Apr 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MOUNT SINAI COMMUNITY FOUNDATION
Doing business as
SMG West Lawn
Practice address
6449 S Pulaski Rd
Ste 211
Chicago, IL 60629-5148
Phone
(773) 581-7300
NPI assigned
Apr 7, 2016
Last updated
Apr 7, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
MOUNT SINAI COMMUNITY FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 7, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John Vazquez, MD
Title
Cmo
Phone
(773) 257-6850

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

6449 S Pulaski Rd
Ste 211
Chicago, IL 60629-5148

Mailing address

6449 S Pulaski Rd
Ste 211
Chicago, IL 60629-5148
Phone (773) 581-7300

Other names 1

  • SMG West Lawn Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mount Sinai Medical Gro53 organizations share this tax ID, including this one
Part of
Mount Sinai Medical Gro

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

Locations

6449 S Pulaski Rd
Ste 211
Chicago, IL 60629
Phone (773) 581-7300

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459987200000",
    "number": "1114381977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6449 S PULASKI RD",
            "address_2": "STE 211",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295148",
            "telephone_number": "773-581-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6449 S PULASKI RD",
            "address_2": "STE 211",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295148",
            "telephone_number": "773-581-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT SINAI COMMUNITY FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOUNT SINAI COMMUNITY FOUNDATION",
        "enumeration_date": "2016-04-07",
        "last_updated": "2016-04-07",
        "status": "A",
        "authorized_official_last_name": "VAZQUEZ",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "773-257-6850",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMG West Lawn",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.