AUNT MARTHA'S YOUTH SERVICE CENTER (NPI# 1962949230) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962949230 |
| Entity Type | Organization |
| Organization Name | AUNT MARTHA'S YOUTH SERVICE CENTER |
| Other Organization Name | AUNT MARTHA'S SEADAC |
| Practice Address |
8640 S South Chicago Ave Chicago IL 60617-2314 |
| Mailing Address |
19990 Governors Hwy Olympia Fields IL 60461-1021 |
| Practice Telephone | 7087477100 |
| Mailing Telephone | 8776928686 |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2017-01-25 |
| Authorized Official Name | MARY MARTIN (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 7088255976 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Aunt Martha's SEADAC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174070676 | Aunt Martha's Youth Service Center | Clinic/Center | 12139 S. Western Ave, Blue Island, IL 60406 | 2016-09-01 |
| 1861637878 | Aunt Martha's Youth Service Center | Community/Behavioral Health | 440 Forest Blvd, Park Forest, IL 60466-2002 | 2008-12-04 |
| 1720258619 | Aunt Martha's Youth Service Center | Community/Behavioral Health | 15020 Cicero Ave, Suite D, Oak Forest, IL 60452-1441 | 2008-03-06 |
| 1295835023 | Aunt Martha's Youth Service Center | Clinic/Center | 8640 S South Chicago Ave, Chicago, IL 60617-2314 | 2006-09-22 |
| 1710424916 | Aunt Martha's Youth Service Center | Clinic/Center | 15350 Oak Park Ave, Oak Forest, IL 60452-1500 | 2017-01-25 |
| 1427508464 | Aunt Martha's Youth Service Center | Clinic/Center | 812 N Logan Ave, Danville, IL 61832-3752 | 2016-10-13 |
| 1982150983 | Aunt Martha's Youth Service Center | Clinic/Center | 511 Dundee Ave, East Dundee, IL 60118-1642 | 2016-08-30 |
| 1912452483 | Aunt Martha's Youth Service Center | Clinic/Center | 3703 Doty Rd, Mob 1, Suite 1, Woodstock, IL 60098-7517 | 2016-08-24 |
| 1851626089 | Aunt Martha's Youth Service Center | Clinic/Center | 755 Pulaski Rd, Calumet City, IL 60409-4030 | 2009-10-06 |
| 1568638500 | Aunt Martha's Youth Service Center | Case Management | 191 W 155th Pl, Harvey, IL 60426-3413 | 2008-04-30 |
| Street Address |
8640 S SOUTH CHICAGO AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60617-2314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295835023 | Aunt Martha's Youth Service Center | Clinic/Center | 8640 S South Chicago Ave, Chicago, IL 60617-2314 | 2006-09-22 |
| 1104365063 | Aunt Martha's Youth Service Center, Inc. | Clinic/Center | 8640 S South Chicago Ave, Chicago, IL 60617-2314 | 2017-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102921 | Manuel Lule | Physical Therapy Assistant | 9535 S Jeffery Boulevard, Chicago, IL 60617 | 2020-07-24 |
| 1083253546 | Vanaja Thotten | Internal Medicine | 8012 S.crandon Ave, Chicago, IL 60617 | 2020-01-02 |
| 1427527365 | Stony Island Dental PC | Dentist | 1600 E 93rd Street, Chicago, IL 60617 | 2018-11-21 |
| 1871060301 | Tamika Nicole Whitehead | Social Worker | 2822 East 83rd Street, Chicago, IL 60617 | 2018-11-02 |
| 1528543774 | Felicia Nwankwo | Nurse Practitioner | 2822 E 83rd Street Bradond Famiy Health Cener, Chicago, IL 60617 | 2018-10-03 |
| 1972099307 | David Phan | Optometrist | 1753 E 95th St Ste B-100, Chicago, IL 60617 | 2018-07-09 |
| 1831607340 | Pamela Evette Ewing | Counselor | 9145 S. Merrill Ave, Chicago, IL 60617 | 2018-01-18 |
| 1366976631 | Ali Mostafa Serhal | Radiology | 240 E. Huron St, Suite 1-203, Chicago, IL 60617 | 2017-04-13 |
| 1447784921 | 1915-25 95th St., LLC | Clinic/Center | 1915 E 95th St, Chicago, IL 60617 | 2017-04-12 |
| 1881140408 | Yeferson Laverde | Social Worker | 3062 East 31st, Chicago, IL 60617 | 2016-09-01 |
| Find all providers in zip 60617 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 1114533924 | A Safe Haven, L.L.C. | Clinic/Center | 600 S Wabash Ave, Chicago, IL 60605-1808 | 2020-09-17 |
| 1235745142 | A Safe Haven, L.L.C. | Clinic/Center | 7355 N Damen Ave, Chicago, IL 60645-2311 | 2020-09-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.