Organization
AUNT MARTHA'S YOUTH SERVICE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER J NORDLOH (CFO)
(708) 747-7100
Entity
Organization
Contact information
Practice address
20301 COTTAGE GROVE AVE, CHICAGO HEIGHTS, IL 60411-9667
(708) 747-7100
(708) 747-0710
Mailing address
19990 GOVERNORS HWY, OLYMPIA FIELDS, IL 60461-1021
(708) 747-7100
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
048
IL
Other
Enumeration date
05/19/2008
Last updated
07/21/2022
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