AUNT MARTHAS YOUTH SERVICE CENTER INC (NPI# 1104954890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104954890 |
| Entity Type | Organization |
| Organization Name | AUNT MARTHAS YOUTH SERVICE CENTER INC |
| Other Organization Name | AUNT MARTHAS AURORA SATELLITE COMMUNITY HEALTH CENTER |
| Practice Address |
317 E Indian Trl Aurora IL 60505-1734 |
| Mailing Address |
19990 Governors Hwy Olympia Fields IL 60461-1021 |
| Practice Telephone | 7087477100 |
| Mailing Telephone | 7087477100 |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2011-03-21 |
| Authorized Official Name | MR. CHRISTOPHER J NORDLOH (CFO) |
| Authorized Official Telephone | 7087477100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
=========050 | IL | Ambulatory Health Care Facilities |
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
=========042 | IL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Aunt Marthas Aurora Satellite Community Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235432436 | Aunt Marthas Youth Service Center Inc | Foster Care Agency | 400 Forest Blvd, Park Forest, IL 60466-2002 | 2010-12-09 |
| 1871724369 | Aunt Marthas Youth Service Center Inc | Clinic/Center | 52 W 162nd St, South Holland, IL 60473-2061 | 2009-07-31 |
| 1336310523 | Aunt Marthas Youth Service Center Inc | Clinic/Center | 602 Torrence Ave, Calumet City, IL 60409-3813 | 2008-03-17 |
| 1811171143 | Aunt Marthas Youth Service Center Inc | Clinic/Center | 3528 E 118th St, Chicago, IL 60617-7314 | 2007-12-21 |
| 1356481899 | Aunt Marthas Youth Service Center Inc | Clinic/Center | 2124 Ogden Ave, Aurora, IL 60504-7595 | 2007-02-07 |
| 1184764730 | Aunt Marthas Youth Service Center Inc | Clinic/Center | 159 E 154th St, Harvey, IL 60426-3325 | 2007-02-06 |
| 1790825347 | Aunt Marthas Youth Service Center Inc | Clinic/Center | 1777 E Court St, Kankakee, IL 60901-2670 | 2007-02-06 |
| 1922148501 | Aunt Marthas Youth Service Center Inc | Clinic/Center | 1536 Vincennes Ave, Chicago Heights, IL 60411-3458 | 2007-02-06 |
| 1144523341 | Aunt Marthas Youth Service Center Inc | Foster Care Agency | 191 W 155th Pl, Harvey, IL 60426-3413 | 2010-12-09 |
| 1619104098 | Aunt Marthas Youth Service Center Inc | Clinic/Center | 19990 Governors Hwy, Olympia Fields, IL 60461-1021 | 2009-06-12 |
| Street Address |
317 E INDIAN TRL |
| City | AURORA |
| State | IL |
| Zip Code | 60505-1734 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538705330 | Johnathan Dunn | Counselor | 140 S. Lincoln Ave., Aurora, IL 60505 | 2019-11-27 |
| 1720638224 | Latanya Rush | Technician | 1664 Briarheath Dr, Aurora, IL 60505 | 2019-09-17 |
| 1285282103 | Susan Burroway | Technician | 815 Pearl St., Aurora, IL 60505 | 2019-09-04 |
| 1629624499 | Jean Amanda Nalwoga | Counselor | 1305 E New Indian Trail, Aurora, IL 60505 | 2019-08-16 |
| 1760987515 | Eric Raul Simental | Preventive Medicine | 1014 Claim St, Aurora, IL 60505 | 2018-03-26 |
| 1518408426 | Oluwole Michael Olubajo | Nurse's Aide | 716 Mountain Street, Apt#2e, Aurora, IL 60505 | 2017-03-10 |
| 1881017960 | Anthony Maranto | Counselor | 1305 E. Indian Trail Ct., Aurora, IL 60505 | 2014-01-27 |
| 1891121141 | Smithhealthcare Properties | Assisted Living Facility | 105 E Galena Bvld #3, Aurora, IL 60505 | 2013-09-18 |
| 1003253865 | Laura A Romero | Speech-Language Pathologist | 1770 Daisy St, Aurora, IL 60505 | 2013-06-03 |
| 1972878197 | Donald C. Kellner Dds-aurora PC | Dentist | 143 South Lincoln Ave, Suite A, Aurora, IL 60505 | 2012-03-21 |
| Find all providers in zip 60505 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1891136149 | Vna Health Care | Clinic/Center | 1400 Indian Avenue, Aurora, IL 60505-3136 | 2013-07-16 |
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| 1568707776 | Metro Community Provider Network, Inc. | Clinic/Center | 15501 East 13th Avenue, Aurora, CO 80011-7203 | 2012-11-29 |
| 1558657312 | Metro Community Provider Network, Inc. | Clinic/Center | 791 Chambers Rd Ste 220, Aurora, CO 80011-7112 | 2011-06-21 |
| 1649430174 | Metro Community Provider Network, Inc. | Clinic/Center | 700 Potomac St Ste A, Aurora, CO 80011-6845 | 2008-06-09 |
| 1912021007 | Vna Health Care | Clinic/Center | 56 Jackson St, Aurora, IL 60505-4300 | 2007-03-16 |
| Find all providers in AURORA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.