Aunt Marthas Youth Service Center

Organization Active NPI Federally Qualified Health Center (FQHC) · Olympia Fields, IL

NPI 1225080922 · NPPES record last updated Dec 2, 2010

Key facts

NPI
1225080922
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
AUNT MARTHAS YOUTH SERVICE CENTER
Practice address
19990 Governors Hwy
Olympia Fields, IL 60461-1021
Phone
(708) 747-7100
NPI assigned
May 17, 2006
Organization subpart
No

Authorized official

Name
Mr. Christopher J Nordloh
Title
Cfo
Phone
(708) 747-7100

Corporate family (same tax ID) 24

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

National Provider Directory

Tax ID family
Aunt Marthas (74 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X IL
Developmentally Disabled Services Day Training Agency 251C00000X IL
Nursing Care Agency 251J00000X IL
Public Health or Welfare Agency 251K00000X IL
Federally Qualified Health Center (FQHC) 261QF0400X 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

All providers in Olympia Fields, IL · Federally Qualified Health Center (FQHC) in Illinois

Sources for this page

Verify at the official NPI Registry.