Aunt Marthas Youth Service
Organization Active NPI Federally Qualified Health Center (FQHC) · Olympia Fields, IL
NPI 1013045707 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1013045707
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- License
- 041 (IL)
- Legal business name
- AUNT MARTHAS YOUTH SERVICE
- Practice address
- 19990 Governors Hwy
Olympia Fields, IL 60461-1021 - Phone
- (708) 747-7100
- NPI assigned
- Mar 2, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Mary M Martin
- Title
- Controller
- Phone
- (708) 747-7100
Corporate family (same tax ID) 13
National Provider Directory
- Tax ID family
- Aunt Marthas
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | 041 | IL | Yes |
Addresses
Primary practice location
19990 Governors Hwy
Olympia Fields, IL 60461-1021
Mailing address
19990 Governors Hwy
Olympia Fields, IL 60461-1021
Phone (708) 747-7100
Other providers in Olympia Fields, IL
- Andrew Tyler Asencio
- Kimberly Aubuchon
- Michelle Nora Augustinas
- Aunt Martha'S Health and Wellness
- Aunt Martha'S Health and Wellness, Inc.
- Aunt Marthas Youth Service Center
- Aunt Marthas Youth Service Center, Inc
- Aunt Matha'S Youth Service Center
- Brennan Scott Ayres
- Shahnaz Azad
All providers in Olympia Fields, IL · Federally Qualified Health Center (FQHC) in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.