AUNT MARTHAS YOUTH SERVICE CENTER INC (NPI# 1811171143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811171143 |
| Entity Type | Organization |
| Organization Name | AUNT MARTHAS YOUTH SERVICE CENTER INC |
| Other Organization Name | AUNT MARTHAS SOUTHEAST SIDE COMMUNITY HEALTH CENTER |
| Practice Address |
3528 E 118th St Chicago IL 60617-7314 |
| Mailing Address |
19990 Governors Hwy Olympia Fields IL 60461-1021 |
| Practice Telephone | 7087477100 |
| Mailing Telephone | 7087477100 |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2011-03-22 |
| 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) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Aunt Marthas Southeast Side 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 |
| 1104954890 | Aunt Marthas Youth Service Center Inc | Clinic/Center | 317 E Indian Trl, Aurora, IL 60505-1734 | 2007-03-02 |
| 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 |
3528 E 118TH ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60617-7314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013431543 | Lawal Garuba | Dentist | 3528 E 118th St, Chicago, IL 60617-7314 | 2017-07-26 |
| 1578729182 | Tamara Chua Lim | Pediatrics | 3528 E 118th St, Chicago, IL 60617-7314 | 2008-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102921 | Manuel Lule | Physical Therapy Assistant | 9535 S Jeffery Boulevard, Chicago, IL 60617 | 2020-07-24 |
| 1083253546 | Vanaja Thotten | Internal Medicine | 8012 S.crandon Ave, Chicago, IL 60617 | 2020-01-02 |
| 1427527365 | Stony Island Dental PC | Dentist | 1600 E 93rd Street, Chicago, IL 60617 | 2018-11-21 |
| 1871060301 | Tamika Nicole Whitehead | Social Worker | 2822 East 83rd Street, Chicago, IL 60617 | 2018-11-02 |
| 1528543774 | Felicia Nwankwo | Nurse Practitioner | 2822 E 83rd Street Bradond Famiy Health Cener, Chicago, IL 60617 | 2018-10-03 |
| 1972099307 | David Phan | Optometrist | 1753 E 95th St Ste B-100, Chicago, IL 60617 | 2018-07-09 |
| 1831607340 | Pamela Evette Ewing | Counselor | 9145 S. Merrill Ave, Chicago, IL 60617 | 2018-01-18 |
| 1366976631 | Ali Mostafa Serhal | Radiology | 240 E. Huron St, Suite 1-203, Chicago, IL 60617 | 2017-04-13 |
| 1447784921 | 1915-25 95th St., LLC | Clinic/Center | 1915 E 95th St, Chicago, IL 60617 | 2017-04-12 |
| 1881140408 | Yeferson Laverde | Social Worker | 3062 East 31st, Chicago, IL 60617 | 2016-09-01 |
| Find all providers in zip 60617 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 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.