| Aunt Martha's Youth Service Center | |
|
755 Pulaski Rd Calumet City IL 60409-4030 | |
| (708) 747-7100 | |
| Not Available |
| Full Name | Aunt Martha's Youth Service Center |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 755 Pulaski Rd, Calumet City, Illinois |
| Authorized Official Name and Position | Christopher Nordloh (CFO) |
| Authorized Official Contact | 7087477100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aunt Martha's Youth Service Center 19990 Governors Hwy Olympia Fields IL 60461-1021 Ph: (708) 747-7100 | Aunt Martha's Youth Service Center 755 Pulaski Rd Calumet City IL 60409-4030 Ph: (708) 747-7100 |
| NPI Number | 1851626089 |
|---|---|
| Provider Enumeration Date | 10/06/2009 |
| Last Update Date | 12/02/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851626089 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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Prabhakar J. Parikh, M.d.p.c Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1851 Sibley Blvd, Calumet City, IL 60409 Phone: 708-868-2300 Fax: 708-868-2304 | |
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