AUNT MARTHA'S YOUTH SERVICE CENTER, INC. is a federally qualified health center (fqhc) clinic center in Chicago, IL. AUNT MARTHA'S YOUTH SERVICE CENTER, INC. NPI is 1780932061. The provider is registered as an organization entity type.
The provider's business location address is:
45 W 111TH ST
CHICAGO, IL
ZIP 60628-200
Phone: (877) 692-8686
Fax: (708) 747-8024
The provider's authorized official is Audrey Pennington .
The authorized official title is Exec. Vp Of Health and has the following contact phone number (773) 802-7645.
The CLIA number assigned to this NPI record is 14D1029242 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).
The enumeration date for this NPI number is 8/17/2012 and was last updated on 11/2/2016.