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Organization

AUNT MARTHAS YOUTH SERVICE CENTER INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AUDREY PENNINGTON (EXEC. VP OF HEALTH)
(773) 802-7645
Entity
Organization

Contact information

Practice address
2124 OGDEN AVE, AURORA, IL 60504-7595
(877) 692-8686
(708) 747-8024
Mailing address
19990 GOVERNORS HWY, OLYMPIA FIELDS, IL 60461-1021
(708) 747-7100
(708) 747-0710

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
IL
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Enumeration date
02/07/2007
Last updated
11/02/2016
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