AUNT MARTHA'S YOUTH SERVICE CENTER, INC (NPI# 1407014046) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407014046 |
| Entity Type | Organization |
| Organization Name | AUNT MARTHA'S YOUTH SERVICE CENTER, INC |
| Practice Address |
1515 Lake St Hanover Park IL 60133-4896 |
| Mailing Address |
19990 Governors Hwy Olympia Fields IL 60461-1021 |
| Practice Telephone | 7087477100 |
| Mailing Telephone | 7087477100 |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2011-01-20 |
| 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 |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
=========049 | IL | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073950044 | Aunt Martha's Youth Service Center, Inc | Clinic/Center | 1200 Eagle Street, Joliet, IL 60432 | 2013-05-30 |
| 1255778221 | Aunt Martha's Youth Service Center, Inc | Clinic/Center | 500 Dixie Highway, Chicago Heights, IL 60411 | 2013-05-30 |
| 1861723611 | Aunt Martha's Youth Service Center, Inc | Clinic/Center | 233 Wjoe Orr Rd, North Building, Chicago Heights, IL 60411 | 2010-01-19 |
| 1881838050 | Aunt Martha's Youth Service Center, Inc | Community Based Residential Treatment Facility, Mental Illness | 1658 Thorn St, Chicago Heights, IL 60411-3453 | 2009-05-01 |
| 1316181597 | Aunt Martha's Youth Service Center, Inc | Community Based Residential Treatment Facility, Mental Illness | 101 Wolpers Rd, Park Forest, IL 60466 | 2009-05-01 |
| 1053555235 | Aunt Martha's Youth Service Center, Inc | Community Based Residential Treatment Facility, Mental Illness | 14449 Vanburen, Dolton, IL 60419 | 2009-05-01 |
| 1427292606 | Aunt Martha's Youth Service Center, Inc | Community Based Residential Treatment Facility, Mental Illness | 1540 Scott Ave, Chicago Heights, IL 60411-3254 | 2009-05-01 |
| 1144464322 | Aunt Martha's Youth Service Center, Inc | Community Based Residential Treatment Facility, Mental Illness | 3125 E 131st St, Chicago, IL 60633-1315 | 2009-05-01 |
| 1417191693 | Aunt Martha's Youth Service Center, Inc | Community Based Residential Treatment Facility, Mental Illness | 123 Salt Lake St, Aurora, IL 60506 | 2009-05-01 |
| 1780828962 | Aunt Martha's Youth Service Center, Inc | Clinic/Center | 23485 Western Ave, Park Forest, IL 60466-2609 | 2009-05-01 |
| Street Address |
1515 LAKE ST |
| City | HANOVER PARK |
| State | IL |
| Zip Code | 60133-4896 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770517070 | Shital B Shah | Family Medicine | 1515 Lake St, Alexian Brother St Alexius Medical Center, Hanover Park, IL 60133 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215302922 | Mangal Dhami | Pharmacist | 1877 Grosse Pointe Circle, Hanove Park, IL 60133 | 2015-12-07 |
| 1649588260 | Church Street Station Skilled Nursing and Living Center, LLC | Skilled Nursing Facility | 2000 W. Lake St., Hanover Park, IL 60133 | 2010-09-16 |
| 1578603395 | Shyam V N Rao | Dentist | 1601 Tanglewood Avenue, Hanover Park, IL 60133 | 2007-02-08 |
| 1851458939 | Robert Jan Bazan | Dentist | 2260 W Irving Pk Rd, Hanover Pk, IL 60133 | 2007-01-02 |
| 1215018635 | Alexian Brothers Corporate Health Services | Clinic/Center | 1515 W Lake Street, Ste 100, Hanover Park, IL 60133 | 2006-10-19 |
| 1225120462 | Hanover Park Physical Medicine & Rehabilitation Ltd | Chiropractor | 1802 Irving Park Road, Hanover Park, IL 60133 | 2006-09-28 |
| 1447350830 | Ismail E Atcha | Internal Medicine | 5420 Cloverdale Road, Hanover Park, ILLINOIS 60133 | 2006-09-25 |
| 1013013374 | Antonio B Cruz | General Practice | 1601 Tanglewood, Suite 106, Hanover Park, IL 60133 | 2006-09-15 |
| 1326143223 | Matthew J Faith | Dentist | 1645 Irving Park Road, Hanover Park, IL 60133 | 2006-09-14 |
| 1992818827 | Ketan Narandas Jobanputra | Obstetrics & Gynecology | 1515 West Lake Street, #208, Alexian Brothers' Hospital Pavilion, Hanover Park, IL 60133 | 2006-08-16 |
| Find all providers in zip 60133 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063963031 | Greater Elgin Family Care Center | Clinic/Center | 1701 Greenbrook Blvd, Hanover Park, IL 60133-5338 | 2016-10-14 |
| 1659602837 | Greater Elgin Family Care Center | Clinic/Center | 1750 Laurel Ave, Hanover Park, IL 60133-3316 | 2010-01-27 |
| 1679809099 | Greater Elgin Family Care Center | Clinic/Center | 2150 Laurel Ave, Hanover Park, IL 60133-3251 | 2009-10-20 |
| 1295060531 | Greater Elgin Family Care Center | Clinic/Center | 2100 Elm Ave, Hanover Park, IL 60133-3808 | 2009-10-05 |
| 1558810960 | Legacy Medical Care Inc | Clinic/Center | 6620 Barrington Rd, Hanover Park, IL 60133-3935 | 2016-09-26 |
| 1861885949 | Greater Elgin Family Care Center | Clinic/Center | 1515 E Lake St, Hanover Park, IL 60133-4869 | 2015-03-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417567108 | Pillars Community Health | Clinic/Center | 15w458 91st St, Burr Ridge, IL 60527-6379 | 2020-08-06 |
| 1932724390 | Friend Family Health Center, Inc | Clinic/Center | 7355 S Jeffery Blvd, Chicago, IL 60649-3121 | 2020-06-11 |
| 1871117937 | Primecare Community Health Inc | Clinic/Center | 1431 N Western Ave Ste 101, Chicago, IL 60622-7712 | 2020-06-04 |
| 1639791569 | Community Health Partnership of Illinois | Clinic/Center | 201 W Kenyon Rd Bldg D, Champaign, IL 61820-7892 | 2020-05-14 |
| 1407482219 | Access Community Health Network | Clinic/Center | 6020 W Diversey Ave Bldg West, Chicago, IL 60639-1108 | 2020-03-13 |
| 1235769704 | Greater Elgin Family Care Center | Clinic/Center | 451 N Mclean Blvd, Elgin, IL 60123-3239 | 2020-01-23 |
| 1710517537 | Greater Elgin Family Care Center Integrated Health Home | Clinic/Center | 1100 Shirley Ave, Streamwood, IL 60107-3068 | 2020-01-21 |
| 1215578109 | Board of Trustees of Southern Illinois University | Clinic/Center | 205 S 24th St Ste 100, Quincy, IL 62301-4446 | 2019-10-02 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1427600345 | The Board of Trustees of The University of Illinois | Clinic/Center | 6835 S Normal Blvd, Chicago, IL 60621-2535 | 2019-07-11 |
| Find all providers with the same taxonomy | ||||
| City | HANOVER PARK |
| Zip Code | 60133 |
Please comment or provide details below to improve the information on AUNT MARTHA'S YOUTH SERVICE CENTER, INC.
| 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.