Aunt Marthas Youth Service Center, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

AUNT MARTHAS YOUTH SERVICE CENTER, INC

Practice address

311 N Ottawa St
Suite 1
Joliet, IL 60432-4048

Phone

(708) 747-7100

NPI assigned

Aug 17, 2012

Last updated

Feb 27, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Christopher J Nordloh

Title

Cfo

Phone

(708) 747-7100

Specialties & licenses 1

Addresses

Locations

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sarada Alla, MD

  • Family Medicine Physician
  • Carpentersville, IL
  • NPI 1770611964
  NPD (past)
• Hemalatha Ayirala, M. D.

  • Family Medicine Physician
  • Aurora, IL
  • NPI 1376601468
  NPD (past)
• Claudette Patricia Caraballo, D.C.

  • Chiropractor
  • Aurora, IL
  • NPI 1073756300
  NPD (past)
• Ernest Antonio Delvecchio, D.C.

  • Chiropractor
  • Aurora, IL
  • NPI 1205944436
  NPD (past)
• Joseph T Glim, LCSW

  • Clinical Social Worker
  • Aurora, IL
  • NPI 1528245099
  NPD (past)
• Saisha Gupta, MD

  • Child & Adolescent Psychiatry Physician
  • Olympia Fields, IL
  • NPI 1083733919
  NPD (past)
• Lauriann Therese Kellner, M.D.

  • Pediatrics Physician
  • Aurora, IL
  • NPI 1710105689
  NPD (past)
• John Vincent Konopelski, APN

  • Family Nurse Practitioner
  • Aurora, IL
  • NPI 1558489393
  NPD (past)
• Cynthia Mata, MD

  • Pediatrics Physician
  • Aurora, IL
  • NPI 1073695847
  NPD (past)
• Julie Ann Reavill, PA-C

  • Medical Physician Assistant
  • Danville, IL
  • NPI 1114197241
  NPD (past)
• Augustine Roland, MD

  • Pediatrics Physician
  • Joliet, IL
  • NPI 1538243134
  NPD (past)
• Smitha Samuel, M.D.

  • Pediatrics Physician
  • Carpentersville, IL
  • NPI 1790977221
  NPD (past)

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

{
    "created_epoch": "1345161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361923200000",
    "number": "1821346115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19990 GOVERNORS HWY",
            "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": "311 N OTTAWA ST",
            "address_2": "SUITE 1",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604324048",
            "telephone_number": "708-747-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUNT MARTHAS YOUTH SERVICE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-17",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Autism Support Chicago LLC
• Autumn Country Club, Inc. (Autumn Adult Day Care)
• Jeshona Iman Averett Butler
• Avid Dental
• Avid Dental PC

• 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 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.