Organization
AUNT MARTHAS YOUTH SERVICE CENTER INC
Active
Other names
Aunt Marthas Southeast Side Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER J NORDLOH (CFO)
(708) 747-7100
Entity
Organization
Contact information
Practice address
3528 E 118TH ST, CHICAGO, IL 60617-7314
(708) 747-7100
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
—
—
Other
Enumeration date
12/21/2007
Last updated
03/22/2011
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