Aunt Martha'S Health and Wellness, Inc.

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

NPI 1396338570 · NPPES record last updated Feb 18, 2021

Key facts

NPI
1396338570
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
AUNT MARTHA'S HEALTH AND WELLNESS, INC.
Practice address
420 NE Glen Oak Ave FL 1
Peoria, IL 61603-3106
Phone
(877) 692-8686
Fax
(708) 747-8024
NPI assigned
Feb 18, 2021
Organization subpart
No

Authorized official

Name
Mrs. Audrey Pennington
Title
Coo
Phone
(773) 802-7645

Corporate family (same tax ID) 24

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

Practitioners 1

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

National Provider Directory

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

Locations

420 NE Glen Oak Ave
Fl 1
Peoria, IL 61603

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

420 NE Glen Oak Ave FL 1
Peoria, IL 61603-3106

Mailing address

19990 Governors Hwy
Olympia Fields, IL 60461-1021
Phone (877) 692-8686

Other names

  • Aunt Martha's Peoria Community Health Center Doing business as

Other providers in Peoria, IL

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

Sources for this page

Verify at the official NPI Registry.