NPIMap

Organization Active NPI

Mt Sinai Pediatric Center

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1780142778
Registry record updated Apr 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MT SINAI PEDIATRIC CENTER
Practice address
2653 W Ogden Ave
Chicago, IL 60608
Phone
(773) 522-2010
NPI assigned
Mar 8, 2019
Organization subpart
Yes
Parent organization
COOK COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 12, 2019

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

Authorized official

Name
Scott Andrle
Title
Director of Managed Care Operations
Phone
(312) 864-4649

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

2653 W Ogden Ave
Chicago, IL 60608

Mailing address

1900 W Polk St Ste 220C
Chicago, IL 60612-3723

Other practice location 1

1500 S Fairfield Ave
Chicago, IL 60608-1782
Phone (773) 542-2000

National Provider Directory

National Provider Directory
Tax ID family
Community Triage Center67 organizations share this tax ID, including this one
Part of
Community Triage Center

Organizations with this tax ID in the same state 24

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

View all 24

Locations

2653 W Ogden Ave
Chicago, IL 60608
Phone (773) 257-6672

NPI Registry JSON

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

{
    "created_epoch": "1552003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555027200000",
    "number": "1780142778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 W POLK ST STE 220C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2653 W OGDEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60608",
            "telephone_number": "773-522-2010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S Fairfield Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606081782",
            "country_code": "US",
            "telephone_number": "773-542-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MT SINAI PEDIATRIC CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COOK COUNTY",
        "enumeration_date": "2019-03-08",
        "last_updated": "2019-04-12",
        "status": "A",
        "authorized_official_last_name": "ANDRLE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "DIRECTOR OF MANAGED CARE OPERATIONS",
        "authorized_official_telephone_number": "312-864-4649"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 12, 2019; 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.