AUNT MARTHA'S YOUTH SERVICE CENTER INC. NPI 1174716823

NPI Information

NPI: 1174716823
Provider Name: AUNT MARTHA'S YOUTH SERVICE CENTER, INC.
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
17850 S KEDZIE AVE
HAZEL CREST, IL
ZIP 60429
Phone: (708) 747-7100
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AUNT MARTHA'S YOUTH SERVICE CENTER, INC. is a federally qualified health center (fqhc) clinic center in Hazel Crest, IL. AUNT MARTHA'S YOUTH SERVICE CENTER, INC. NPI is 1174716823. The provider is registered as an organization entity type.

The provider's business location address is:

17850 S KEDZIE AVE
HAZEL CREST, IL
ZIP 60429-058
Phone: (708) 747-7100

The provider's authorized official is Christopher J Nordloh .
The authorized official title is Cfo and has the following contact phone number (708) 747-7100.

The enumeration date for this NPI number is 8/24/2007 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	044	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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