Aunt Martha'S Youth Service Center Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

077 Issued in IL

Legal business name

AUNT MARTHA'S YOUTH SERVICE CENTER INC

Practice address

1301 Copperfield Avenue
Suite 201
Joliet, IL 60432-2056

Phone

(708) 747-7100

NPI assigned

Oct 31, 2011

Organization subpart

No

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

Authorized official

Name

Christopher J Nordloh

Title

Cfo

Phone

(708) 747-7100

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Augustine Roland, MD

  • Pediatrics Physician
  • Joliet, IL
  • NPI 1538243134
  NPD (past)

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

{
    "created_epoch": "1320019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1174809503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19990 GOVERNORS HIGHWAY",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611021",
            "telephone_number": "708-747-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 COPPERFIELD AVENUE",
            "address_2": "SUITE 201",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604322056",
            "telephone_number": "708-747-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUNT MARTHA'S YOUTH SERVICE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-31",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NORDLOH",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "708-747-7100"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "IL",
            "license": "077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jurizon Atienza
• Aunt Martha'S Health and Wellness, Inc.
• Aunt Martha'S Health and Wellness, Inc.
• Aunt Martha'S Health and Wellness, Inc.
• Aunt Martha'S Youth Service Center in
• Aunt Martha'S Youth Service Center Inc
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• Aunt Marthas Youth Service Center, Inc
• Autism Support Chicago LLC

• Federally Qualified Health Center (FQHC) in Joliet, IL
• Providers in Joliet, IL by specialty
• Federally Qualified Health Center (FQHC) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.