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Mt Sinai Pediatric Center FFS

Organization Active NPI Family Medicine Physician · Chicago, IL

NPI 1891329488 · NPPES record last updated May 22, 2020

Key facts

NPI
1891329488
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
MT SINAI PEDIATRIC CENTER FFS
Practice address
2653 W Ogden Ave
Chicago, IL 60608-1647
Phone
(773) 522-2010
NPI assigned
Feb 24, 2020
Organization subpart
Yes
Parent organization (as reported)
COOK COUNTY

Authorized official

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

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Cook County General Acute Care Hospital · Chicago, IL · NPI 1487664561
    CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST
  • Cook County Renal Dialysis Technician · Chicago, IL · NPI 1578170221
    CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST
  • Cook County General Acute Care Hospital · Chicago, IL · NPI 1588612832
    CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST
  • Cook County End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Chicago, IL · NPI 1821278938
    CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST

Other NPIs on the same Medicare enrollment 26

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 26

Corporate family (same tax ID) 20

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

Affiliated clinicians 673

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 673

Medicare Care Compare: Hospital

Listed as
John H Stroger Jr Hospital CCN 140124
Overall star rating
★★☆☆☆ 2 of 5
Type
Acute Care Hospitals
Ownership
Government - Local
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

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 · Non-profit
Incorporated
Jan 1, 1866 in IL
Enrollment address
1901 W Harrison St
Chicago, IL 60612-3714
Main/Primary Hospital Location
Hospital subgroups
General, Acute care, Other

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.

NameRoleSinceShare
Eze Peter Nwaezeigwe
Individual 		Corporate Director
Director of Finance		 Nov 13, 2018
W-2 Managing Employee
Director of Finance		 Nov 13, 2018
Cook County
Organization · Chicago, IL
Non-profit 		5% Or Greater Direct Ownership Interest Oct 27, 2010 100%
Scott Spencer
Individual 		Corporate Officer Dec 29, 2025

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
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

National Provider Directory

Tax ID family
Community Triage Center (67 organizations share this tax ID)
Part of
Community Triage Center

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 207Q00000X Yes

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

  • MT SINAI PEDIATRIC CENTER FFS Doing business as

Other providers in Chicago, IL

All providers in Chicago, IL · Family Medicine Physician in Illinois

Sources for this page

Verify at the official NPI Registry.