Active NPI
Mt Sinai Pediatric Center FFS
- Family Medicine Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- MT SINAI PEDIATRIC CENTER FFS
- Doing business as
- Mt Sinai Pediatric Center FFS
- Practice address
- 2653 W Ogden Ave
Chicago, IL 60608-1647 - Phone
- (773) 522-2010
- NPI assigned
- Feb 24, 2020
- Last updated
- May 22, 2020
- Organization subpart
- Yes
- Parent organization
- COOK COUNTY
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
2653 W Ogden Ave
Chicago, IL 60608-1647
Mailing address
1900 W Polk St RM 220C
Chicago, IL 60612-3723
Other names 1
- MT SINAI PEDIATRIC CENTER FFS
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101228000196 | IL | Part A Provider - Hospital | 2860398088 |
26 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Arlington Heights, IL; Robbins, IL; North Riverside, IL; Ford Heights, IL; Cicero, IL; Chicago, IL; Blue Island, IL |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1891329488. Details of each certification follow.
Hospital certification: CCN 140124
- Legal name
- COOK COUNTY
- Doing business as
- JOHN H. STROGER, JR HOSPITAL OF COOK COUNTY
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Mar 12, 2016
- Beds
- 918
- Ownership / control type
- Local
- Organization structure
- Government
- Incorporated
- Jan 1, 1866 in IL
- Enrollment address
- 1901 W Harrison St
Chicago, IL 60612-3714 - Hospital subgroups
- General, Acute care, Other
Other NPIs on the same Medicare enrollment 26
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Cook County Health at Blue Island Health Center
- Clinic Pharmacy
- Blue Island, IL
- NPI 1043238298
O20101228000196
-
dba Robbins Health Center (FFS)
- Family Medicine Physician
- Robbins, IL
- NPI 1053942045
O20101228000196
-
dba Cook County Health - S - UA
- Multi-Specialty Clinic/Center
- Chicago, IL
- NPI 1093283533
O20101228000196
-
dba Cook County Health at North Riverside Health (FFS)
- Family Medicine Physician
- North Riverside, IL
- NPI 1295366466
O20101228000196
-
dba Woody Winston Health Center
- Primary Care Clinic/Center
- Phoenix, IL
- NPI 1336269133
O20101228000196
-
dba Ruth M. Rothstein CORE Center (FFS)
- Family Medicine Physician
- Chicago, IL
- NPI 1366073256
O20101228000196
-
dba Arlington Heights Health Center (FFS)
- Family Medicine Physician
- Arlington Heights, IL
- NPI 1366073355
O20101228000196
-
dba Cook County Health Professional Building
- Multi-Specialty Clinic/Center
- Chicago, IL
- NPI 1386110674
O20101228000196
-
dba Near South Health Cener
- Primary Care Clinic/Center
- Chicago, IL
- NPI 1396865077
O20101228000196
-
dba Cottage Grove Health Center (FFS)
- Family Medicine Physician
- Ford Heights, IL
- NPI 1427689413
O20101228000196
-
dba Oak Forest Health Center (FFS)
- Family Medicine Physician
- Oak Forest, IL
- NPI 1457982340
O20101228000196
-
dba Morton East Adolescent Health Center (FFS)
- Family Medicine Physician
- Cicero, IL
- NPI 1457982449
O20101228000196
Care Compare: Hospital
Medicare Care Compare- Listed as
- John H Stroger Jr Hospital
- Overall star rating
- Type
- Acute Care Hospitals
- Ownership
- Government - Local
- Medicare certification status
- Active
- Emergency services
- Yes
National Provider Directory
National Provider Directory- Tax ID family
- Community Triage Center
- Part of
- Community Triage Center
Organizations with this tax ID in the same state 20
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Community/Behavioral Health Agency
- Chicago, IL
- NPI 1922549294
-
dba Children's Advocacy Center (FFS)
- Family Medicine Physician
- Chicago, IL
- NPI 1740811736
-
dba Logan Square Health Center (FFS)
- Family Medicine Physician
- Chicago, IL
- NPI 1750912648
-
dba John H. Stroger, Jr. Hospital BC Outpatient Pharmacy
- Institutional Pharmacy
- Chicago, IL
- NPI 1770892135
-
dba Cook County Health at Blue Island
- Geriatric Medicine (Family Medicine) Physician
- Blue Island, IL
- NPI 1780205708
-
dba Central Campus Specialty Care Clinic (FFS)
- Family Medicine Physician
- Chicago, IL
- NPI 1790316784
-
dba John H. Stroger, Jr. Hospital of Cook County
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Chicago, IL
- NPI 1821278938
-
dba Provident Dialysis Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Chicago, IL
- NPI 1831846922
-
dba Cook County Health Central Fill Pharmacy
- Mail Order Pharmacy
- Chicago, IL
- NPI 1942508460
Locations
2653 W Ogden Ave
Chicago, IL 60608
Phone (773) 257-6672
Ownership & related parties
All disclosed owners & managing parties 3
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Eze Peter Nwaezeigwe | Corporate Director | Nov 13, 2018 | |
| W-2 Managing Employee | Nov 13, 2018 | ||
| Cook County | 5% Or Greater Direct Ownership Interest | Oct 27, 2010 | 100% |
| Scott Spencer | Corporate Officer | Dec 29, 2025 |
Owners & managing parties with NPI records 4
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
dba Provident Hospital of Cook County
- General Acute Care Hospital
- Chicago, IL
- NPI 1487664561
5% Or Greater Direct Ownership Interest
-
dba Provident Dialysis Center
- Renal Dialysis Technician
- Chicago, IL
- NPI 1578170221
5% Or Greater Direct Ownership Interest
-
dba John H. Stroger, Jr. Hospital of Cook County
- General Acute Care Hospital
- Chicago, IL
- NPI 1588612832
5% Or Greater Direct Ownership Interest
-
dba John H. Stroger, Jr. Hospital of Cook County
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Chicago, IL
- NPI 1821278938
5% Or Greater Direct Ownership Interest
Practitioners & affiliated clinicians
Practitioners 328
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Gastroenterology Physician
- Maywood, IL
- NPI 1194031435
-
- Family Nurse Practitioner
- Chicago, IL
- NPI 1548724578
-
- Nephrology Physician
- Chicago, IL
- NPI 1144550088
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1861712903
-
- Optometrist
- Oak Forest, IL
- NPI 1437292356
-
- Physician Assistant
- Chicago, IL
- NPI 1982337572
-
- Family Medicine Physician
- Chicago, IL
- NPI 1083238281
-
- Family Medicine Physician
- Worth, IL
- NPI 1124051339
-
- Neonatal-Perinatal Medicine Physician
- Chicago, IL
- NPI 1710093810
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1942453022
-
- Family Nurse Practitioner
- Chicago, IL
- NPI 1083364707
-
- Internal Medicine Physician
- Evanston, IL
- NPI 1487069597
Affiliated clinicians 673
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Hospitalist Physician
- Chicago, IL
- NPI 1154841286
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582502400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1590105600000",
"number": "1891329488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 W POLK ST RM 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": "606081647",
"telephone_number": "773-522-2010"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MT SINAI PEDIATRIC CENTER FFS",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "COOK COUNTY",
"enumeration_date": "2020-02-24",
"last_updated": "2020-05-22",
"certification_date": "2020-05-22",
"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": "207Q00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "MT SINAI PEDIATRIC CENTER FFS",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "MT SINAI PEDIATRIC CENTER FFS",
"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 May 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.