| Aunt Martha's Rockford Community Health Center | |
|
345 Executive Pkwy Ste L1 Rockford IL 61107-5291 | |
| (877) 692-8686 | |
| Not Available |
| Full Name | Aunt Martha's Rockford Community Health Center |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 345 Executive Pkwy Ste L1, Rockford, Illinois |
| Authorized Official Name and Position | Audrey Pennington (COO) |
| Authorized Official Contact | 7738027645 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aunt Martha's Rockford Community Health Center 19990 Governors Hwy Olympia Fields IL 60461-1021 Ph: (708) 747-7100 | Aunt Martha's Rockford Community Health Center 345 Executive Pkwy Ste L1 Rockford IL 61107-5291 Ph: (877) 692-8686 |
| NPI Number | 1043746720 |
|---|---|
| Provider Enumeration Date | 05/02/2017 |
| Last Update Date | 09/29/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043746720 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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