AUNT MARTHA'S YOUTH SERVICE CENTER, INC. (NPI# 1487191540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487191540 |
| Entity Type | Organization |
| Organization Name | AUNT MARTHA'S YOUTH SERVICE CENTER, INC. |
| Other Organization Name | AUNT MARTHA'S ADAPT |
| Practice Address |
1777 E Court St Lower Level Kankakee IL 60901-2670 |
| Mailing Address |
19990 Governors Hwy Olympia Fields IL 60461-1021 |
| Practice Telephone | 8776928686 |
| Mailing Telephone | 8776928686 |
| Enumeration Date | 2017-01-27 |
| Last Update Date | 2017-01-27 |
| Authorized Official Name | MARY MARTIN (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 7088255976 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Aunt Martha's ADAPT | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205386638 | Aunt Martha's Youth Service Center, Inc. | Clinic/Center | 15420 Dixie Hwy, Harvey, IL 60426-3478 | 2016-10-10 |
| 1538519111 | Aunt Martha's Youth Service Center, Inc. | Clinic/Center | 15350 Oak Park Ave., Oak Forest, IL 60452 | 2016-06-15 |
| 1174716823 | Aunt Martha's Youth Service Center, Inc. | Clinic/Center | 17850 S Kedzie Ave, Hazel Crest, IL 60429-2058 | 2007-08-24 |
| 1104365063 | Aunt Martha's Youth Service Center, Inc. | Clinic/Center | 8640 S South Chicago Ave, Chicago, IL 60617-2314 | 2017-02-13 |
| 1619427655 | Aunt Martha's Youth Service Center, Inc. | Clinic/Center | 15420 Dixie Hwy, Harvey, IL 60426-3478 | 2016-10-13 |
| 1780932061 | Aunt Martha's Youth Service Center, Inc. | Clinic/Center | 45 W 111th St, Chicago, IL 60628-4200 | 2012-08-17 |
| 1104054386 | Aunt Martha's Youth Service Center, Inc. | Clinic/Center | 17850 Kedzie Ave, Suite 3200, Hazel Crest, IL 60429-2058 | 2009-06-26 |
| Street Address |
1777 E COURT ST LOWER LEVEL |
| City | KANKAKEE |
| State | IL |
| Zip Code | 60901-2670 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790825347 | Aunt Marthas Youth Service Center Inc | Clinic/Center | 1777 E Court St, Kankakee, IL 60901-2670 | 2007-02-06 |
| 1861965543 | Angela D Beal | Nurse Practitioner | 1777 E Court St, Kankakee, IL 60901-2670 | 2019-01-06 |
| 1932675006 | Glory Obianuju Ikerodah | Nurse Practitioner | 1777 E Court St, Kankakee, IL 60901-2670 | 2018-10-16 |
| 1467991323 | Aunt Martha's Youth Service Center, Inc | Clinic/Center | 1777 E Court St, Lower Level, Kankakee, IL 60901-2670 | 2017-02-13 |
| 1205235884 | Jutun R Andrews-king | Nurse Practitioner | 1777 E Court St, Kankakee, IL 60901-2670 | 2014-08-19 |
| 1396070520 | Aunt Martha's Youth Service Center Inc | Community/Behavioral Health | 1777 E Court St, Kankakee, IL 60901-2670 | 2009-10-06 |
| 1790949808 | Hemavathi Patil | Dentist | 1777 E Court St, Kankakee, IL 60901-2670 | 2008-07-17 |
| 1538339411 | Aunt Martha's Youth Service Center Inc | Community/Behavioral Health | 1777 E Court St, Kankakee, IL 60901-2670 | 2008-03-06 |
| 1972705192 | Aunt Martha's Youth Service Center | Clinic/Center | 1777 E Court St, Lower Level, Kankakee, IL 60901-2670 | 2007-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558978841 | William Mitsos Dds | Dentist | 1291 S. 7th Ave, Kankakee, IL 60901 | 2020-09-30 |
| 1922653682 | Jody Mcguyer, Lcpc, Cadc Counseling Services, LLC | Counselor | 315 W. Court St., Kankakee, IL 60901 | 2019-08-08 |
| 1700346327 | Sarah Elizabeth Toma | Speech-Language Pathologist | 200 E Court St #708, Kankakee, IL 60901 | 2019-03-20 |
| 1710473160 | Small Talk Speech Services, LLC | Clinic/Center | 1439 W Vanmeter St, Kankakee, IL 60901 | 2018-07-09 |
| 1124538004 | Amy J Green | Physical Therapist | 350 N. Wall Street, Kankakee, IL 60901 | 2017-10-05 |
| 1013457514 | Elizabeth Ann Smith | Registered Nurse | 292 Charlton Lane, Kankakee, IL 60901 | 2017-03-02 |
| 1861931461 | Stacey E. Brown | Nurse Practitioner | 207 N. Schuyler Ave., Kankakee, IL 60901 | 2017-02-15 |
| 1417352105 | Provider Healthcare Services, Inc | Home Health | 555 South Schuyler, Suite 275, Kankakee, IL 60901 | 2014-10-24 |
| 1265850655 | Ronald George Testa | Dentist | 202 N. Schuyler Ave, Kankakee, IL 60901 | 2014-04-02 |
| 1245587898 | Mary Beth Wertz | Registered Nurse | 100 N Jeffery Street, Kankakee, IL 60901 | 2012-08-13 |
| Find all providers in zip 60901 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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|---|---|---|---|---|
| 1831719913 | Cornerstone Services Inc | Clinic/Center | 187 S Schuyler Ave Ste 450, Kankakee, IL 60901-3835 | 2020-04-20 |
| 1427118439 | Oakside Corporation | Clinic/Center | 1905 W Court St, Entrance A, Kankakee, IL 60901-3163 | 2006-12-11 |
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| 1194322370 | Envision Unlimited | Clinic/Center | 4911 S Hoyne Ave, Chicago, IL 60609-4721 | 2020-10-01 |
| Find all providers with the same taxonomy | ||||
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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.