AUNT MARTHA'S YOUTH SERVICE CENTER, INC. (NPI# 1780932061) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780932061 |
| Entity Type | Organization |
| Organization Name | AUNT MARTHA'S YOUTH SERVICE CENTER, INC. |
| Practice Address |
45 W 111th St Chicago IL 60628-4200 |
| Mailing Address |
19990 Governors Hwy Olympia Fields IL 60461-1021 |
| Practice Telephone | 8776928686 |
| Practice Fax Number | 7087478024 |
| Mailing Telephone | 7087477100 |
| Mailing Fax Number | 7087470710 |
| Enumeration Date | 2012-08-17 |
| Last Update Date | 2016-11-02 |
| Authorized Official Name | AUDREY PENNINGTON (EXEC. VP OF HEALTH) |
| Authorized Official Telephone | 7738027645 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| 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 |
| 1487191540 | Aunt Martha's Youth Service Center, Inc. | Clinic/Center | 1777 E Court St, Lower Level, Kankakee, IL 60901-2670 | 2017-01-27 |
| 1619427655 | Aunt Martha's Youth Service Center, Inc. | Clinic/Center | 15420 Dixie Hwy, Harvey, IL 60426-3478 | 2016-10-13 |
| 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 |
45 W 111TH ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60628-4200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245222454 | Carl Vancol | Family Medicine | 45 W 111th St, Suite 304, Chicago, IL 60628-4200 | 2005-08-16 |
| 1740897149 | Healthcare Alternative Systems, Inc. | Clinic/Center | 45 W 111th St, Chicago, IL 60628-4200 | 2020-09-29 |
| 1659988053 | Healthcare Alternative Systems, Inc. | Clinic/Center | 45 W 111th St, Chicago, IL 60628-4200 | 2020-09-29 |
| 1003371717 | Shakira Ayanlaja | Nurse Practitioner | 45 W 111th St, Chicago, IL 60628-4200 | 2019-02-06 |
| 1265997142 | Roseland Community Hospital Association | Dentist | 45 W 111th St, Chicago, IL 60628-4200 | 2019-02-05 |
| 1063918555 | Brenda Beben | Dietitian, Registered | 45 W 111th St, Chicago, IL 60628-4200 | 2018-04-03 |
| 1730687591 | Tranisha Lynette Lucas | Nurse Practitioner | 45 W 111th St, Chicago, IL 60628-4200 | 2018-01-26 |
| 1386152395 | Rjm Wellness Corp | Internal Medicine | 45 W 111th St, Chicago, IL 60628-4200 | 2018-01-12 |
| 1760998280 | Anum Haq | Physician Assistant | 45 W 111th St, Chicago, IL 60628-4200 | 2017-12-20 |
| 1780110346 | Roxanne Spurlark | Nurse Practitioner | 45 W 111th St, Chicago, IL 60628-4200 | 2017-05-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750857942 | Myrna Pledger | Counselor | 259 W. 104th Pl., Chicago, IL 60628 | 2018-10-16 |
| 1073097184 | 4every1 Lab Inc. | Clinical Medical Laboratory | 10723 S Halsted St, Chicago, IL 60628 | 2018-09-24 |
| 1922594613 | Northwest Adult Wellness Center LLC | Clinic/Center | 235 W 95th Suite 3, Chicago, IL 60628 | 2018-07-05 |
| 1285152801 | Brittany Bellamy | Developmental Therapist | 10333 S Prairie, Chicago, IL 60628 | 2017-09-04 |
| 1598293839 | Denise Marie Mercherson | Social Worker | 9561 S. Union, Chicago, IL 60628 | 2017-05-31 |
| 1659821221 | Tca Health Care | Dentist | 1030 E. 130th St, Chicago, IL 60628 | 2016-10-07 |
| 1528432697 | Global Dialysis, LLC | Registered Nurse | 9746 South Harvard Ave., Chicago, IL 60628 | 2015-11-30 |
| 1871966382 | Kirby Rehabilitation, Inc | Clinic/Center | 723 W. 111th St, Chicago, IL 60628 | 2015-11-05 |
| 1851638605 | Marketa Marvanova | Pharmacist | 9501 S. King Drive, Douglas Hall 203-23, Chicago State University College of Pharmacy, Chicago, IL 60628 | 2013-01-14 |
| 1841567377 | Emma Goodman | Pharmacist | 10620 S. Halsted St, Chicago, IL 60628 | 2011-11-29 |
| Find all providers in zip 60628 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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|---|---|---|---|---|
| 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 |
| 1407482219 | Access Community Health Network | Clinic/Center | 6020 W Diversey Ave Bldg West, Chicago, IL 60639-1108 | 2020-03-13 |
| 1427600345 | The Board of Trustees of The University of Illinois | Clinic/Center | 6835 S Normal Blvd, Chicago, IL 60621-2535 | 2019-07-11 |
| 1114498540 | Pcc Community Wellness Center | Clinic/Center | 115 N Parkside Ave Fl 1, Chicago, IL 60644-3040 | 2018-12-11 |
| 1427523125 | Howard Brown Health Center | Clinic/Center | 3533 W North Ave Ste 1, Chicago, IL 60647-7573 | 2018-10-09 |
| 1336626936 | Heartland International Health Center | Clinic/Center | 1631 W Jonquil Ter, Chicago, IL 60626-1103 | 2018-07-26 |
| 1760975304 | Inner-city Muslim Action Network | Clinic/Center | 2744 W 63rd St Bldg 2, Chicago, IL 60629-2343 | 2018-06-08 |
| 1417473851 | Howard Brown Health Center | Clinic/Center | 2800 N Sheridan Rd Ste 211, Chicago, IL 60657-6161 | 2017-08-17 |
| 1487193181 | Mile Square Englewood/cook Satellite Health and Wellness Center | Clinic/Center | 8150 S Bishop St, Chicago, IL 60620-3854 | 2017-02-15 |
| Find all providers in CHICAGO | ||||
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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.