NPIMap

Organization Active NPI

Aunt Martha's Youth Service Center

  • Federally Qualified Health Center (FQHC)
  • Calumet City, IL
National Provider Identifier
1851626089
Registry record updated Dec 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
AUNT MARTHA'S YOUTH SERVICE CENTER
Practice address
755 Pulaski Rd
Calumet City, IL 60409-4030
Phone
(708) 747-7100
NPI assigned
Oct 6, 2009
Last updated
Dec 2, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2010

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

755 Pulaski Rd
Calumet City, IL 60409-4030

Mailing address

19990 Governors Hwy
Olympia Fields, IL 60461-1021
Phone (708) 747-7100

National Provider Directory

National Provider Directory
Tax ID family
Aunt Martha's Youth Service74 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

Locations

755 Pulaski Rd
Calumet City, IL 60409
Phone (708) 585-1036

NPI Registry JSON

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

{
    "created_epoch": "1254787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291248000000",
    "number": "1851626089",
    "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": "755 PULASKI RD",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604094030",
            "telephone_number": "708-747-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUNT MARTHA'S YOUTH SERVICE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-06",
        "last_updated": "2010-12-02",
        "status": "A",
        "authorized_official_last_name": "NORDLOH",
        "authorized_official_first_name": "CHRISTOPHER",
        "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": []
}

Other providers in Calumet City, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; 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.