AUNT MATHA'S YOUTH SERVICE CENTER (NPI# 1902269095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902269095 |
| Entity Type | Organization |
| Organization Name | AUNT MATHA'S YOUTH SERVICE CENTER |
| Practice Address |
19990 Governors Hwy Olympia Fields IL 60461-1021 |
| Mailing Address |
898 Brompton Cir Bolingbrook IL 60440-1485 |
| Practice Telephone | 7087477100 |
| Mailing Telephone | 8474209664 |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2016-04-05 |
| Authorized Official Name | DR. CLARENCE PARKS (PCP - FAMILY PRACTICE MEDICINE) |
| Authorized Official Telephone | 8152751540 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
1275992323 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | NATIONAL PLAN & PROVIDER ENUMERATION | 1275992323 | 01 |
| Street Address |
19990 GOVERNORS HWY |
| City | OLYMPIA FIELDS |
| State | IL |
| Zip Code | 60461-1021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225080922 | Aunt Marthas Youth Service Center | Case Management | 19990 Governors Hwy, Olympia Fields, IL 60461-1021 | 2006-05-17 |
| 1063041861 | Benjamin Drew Sanders | Counselor | 19990 Governors Hwy, None, Olympia Fields, IL 60461-1021 | 2020-04-03 |
| 1740835321 | General Hood Md Inc | Obstetrics & Gynecology | 19990 Governors Hwy, Olympia Fields, IL 60461-1021 | 2019-08-09 |
| 1912489188 | Aunt Martha's Health and Wellness | Case Manager/Care Coordinator | 19990 Governors Hwy, Olympia Fields, IL 60461 | 2018-09-04 |
| 1336631100 | Jasmin Scott | Nurse Practitioner | 19990 Governors Hwy, Olympia Fields, IL 60461-1021 | 2018-06-06 |
| 1588198295 | Michael Hanson | Social Worker | 19990 Governors Hwy, Olympia Fields, IL 60461-1021 | 2017-04-19 |
| 1902348592 | Krista Raatjes | Social Worker | 19990 Governors Hwy, Olympia Fields, IL 60461-1021 | 2016-11-14 |
| 1275992323 | Arthur Pilapil Oliveros | Nurse Practitioner | 19990 Governors Hwy, Olympia Fields, IL 60461-1021 | 2016-02-17 |
| 1609124676 | Aunt Marthas Youth Service Center, Inc | Clinic/Center | 19990 Governors Hwy, Olympia Fields, IL 60461-1021 | 2012-08-24 |
| 1154679116 | Aunt Martha's Health Center West Joliet | Clinic/Center | 19990 Governors Hwy, Olympia Fields, IL 60461-1021 | 2012-08-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609372564 | Katherine Gill Haddad | Student in an Organized Health Care Education/Training Program | 20201 S. Crawford Avenue, Attn: Postdoctoral Education, Olympia Fields, IL 60461 | 2018-03-31 |
| 1750886610 | Kim Minh Dang | Student in an Organized Health Care Education/Training Program | 20201 South Crawford, Olympia Fields, IL 60461 | 2018-03-23 |
| 1619484110 | Alexandra N. Douvas | Dentist | 20180 Governors Hwy, Ste 104, Olympia Fields, IL 60461 | 2018-01-05 |
| 1992258438 | Krystyne Doty | Nurse Practitioner | 3800 W 203rd St Ste 209, Olympia Fields, IL 60461 | 2016-08-02 |
| 1205286747 | Shirlene Umali | Registered Nurse | 20201 South Crawford Ave, Olympia Fields, IL 60461 | 2016-06-15 |
| 1386002590 | Touch of Wholeness Psychological Services, LLC | Psychologist | 20280 Governors Dr, Suite 207, Olympia Fields, IL 60461 | 2016-02-02 |
| 1063895357 | David Dardick | Dentist | 20180 Governors Hwy Ste 104, Olympia Fields, IL 60461 | 2015-07-04 |
| 1811378623 | Fins Healthcare Agency | Nursing Care | 3612 Lincohn Highway, Suite 19, Olympia Fields, IL 60461 | 2015-06-17 |
| 1285048959 | Garud Ranga Raj | Orthopaedic Surgery | 20817 Alexander St, Olympia Fields, IL 60461 | 2014-06-20 |
| 1811316334 | Brett Hapeman | Emergency Medicine | 20201 S Crawford, Attn: Postdoctoral Education, Olympia Fields, IL 60461 | 2014-04-11 |
| Find all providers in zip 60461 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
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| 1396389417 | Hirsch Advanced Practice Providers Ltd | Clinic/Center | 11422 S Western Ave, Chicago, IL 60643-4120 | 2019-10-31 |
| 1497308761 | Exquisite Care Spa and Wellness Inc. | Clinic/Center | 3257 N Sheffield Ave Ste 116, Chicago, IL 60657-2276 | 2019-07-16 |
| 1437612405 | Voice of Reason Counseling, LLC | Clinic/Center | 6634 S Knox Ave, Chicago, IL 60629-5643 | 2019-04-08 |
| 1215499405 | Leading Physician Partners Aco LLC | Clinic/Center | 715 W Lake St Ste 202, Addison, IL 60101-2082 | 2019-04-05 |
| 1346708815 | Erin Conway, Psyd, PC | Clinic/Center | 444 S Rand Rd Ste 214, Lake Zurich, IL 60047-2307 | 2019-03-04 |
| 1891252078 | Essence Healthcare Services LLC | Clinic/Center | 10449 Venice Ln, Orland Park, IL 60467-8218 | 2019-02-25 |
| Find all providers with the same taxonomy | ||||
| City | OLYMPIA FIELDS |
| Zip Code | 60461 |
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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.