NPIMap

Organization Active NPI

Mount Sinai Hospital Medical Center

Doing business as Pioneer House

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
National Provider Identifier
1750678934
Registry record updated Dec 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
0001644 Issued in IL
Legal business name
MOUNT SINAI HOSPITAL MEDICAL CENTER
Doing business as
Pioneer House
Practice address
812 S Western Ave
Chicago, IL 60612-4140
Phone
(312) 666-6897
NPI assigned
Jul 7, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2016

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

Authorized official

Name
Karen C Teitelbaum
Title
Executive Vice President/Coo
Phone
(773) 257-5332

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 0001644 IL Primary

Addresses

Primary practice location

812 S Western Ave
Chicago, IL 60612-4140

Mailing address

812 S Western Ave
Chicago, IL 60612-4140
Phone (312) 666-6897

Other identifiers 2

IdentifierTypeStateIssuer
1932496114MedicaidIL
1639470867MedicaidIL

Other names 1

  • Pioneer House Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mt Sinai Hospital21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

Locations

812 S Western Ave
Chicago, IL 60612
Phone (312) 666-6897

NPI Registry JSON

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482105600000",
    "number": "1750678934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124140",
            "telephone_number": "312-666-6897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124140",
            "telephone_number": "312-666-6897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT SINAI HOSPITAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-07",
        "last_updated": "2016-12-19",
        "status": "A",
        "authorized_official_last_name": "TEITELBAUM",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT/COO",
        "authorized_official_telephone_number": "773-257-5332"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IL",
            "license": "0001644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932496114",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639470867",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pioneer House",
            "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 Dec 19, 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.