NPIMap

Organization Active NPI

Aunt Marthas Youth Service Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Olympia Fields, IL
National Provider Identifier
1609124676
Registry record updated Feb 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
AUNT MARTHAS YOUTH SERVICE CENTER, INC
Practice address
19990 Governors Hwy
Olympia Fields, IL 60461-1021
Phone
(708) 747-7100
NPI assigned
Aug 24, 2012
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Christopher J Nordloh
Title
Cfo
Phone
(708) 747-7100

National Provider Directory

National Provider Directory
Tax ID family
Aunt Marthas74 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

NPPES NPI Registry

Primary practice location

19990 Governors Hwy
Olympia Fields, IL 60461-1021

Mailing address

1301 Copperfield Ave
Suite 202
Joliet, IL 60432-2054

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 27, 2013.

{
    "created_epoch": "1345766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361923200000",
    "number": "1609124676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 COPPERFIELD AVE",
            "address_2": "SUITE 202",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604322054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19990 GOVERNORS HWY",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611021",
            "telephone_number": "708-747-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUNT MARTHAS YOUTH SERVICE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-24",
        "last_updated": "2013-02-27",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia Fields, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; 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.