| Aunt Martha's Youth Service Center, Inc | |
|
14424 S Wentworth Ave Riverdale IL 60827-2729 | |
| (708) 747-7100 | |
| Not Available |
| Full Name | Aunt Martha's Youth Service Center, Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 14424 S Wentworth Ave, Riverdale, Illinois |
| Authorized Official Name and Position | Christopher J 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, Inc 19990 Governors Hwy Olympia Fields IL 60461-1021 Ph: (708) 747-7100 | Aunt Martha's Youth Service Center, Inc 14424 S Wentworth Ave Riverdale IL 60827-2729 Ph: (708) 747-7100 |
| NPI Number | 1427292788 |
|---|---|
| Provider Enumeration Date | 04/29/2009 |
| Last Update Date | 12/02/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427292788 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Sunrise Clinical Health Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 502 W 138th Street, Riverdale, IL 60827 Phone: 312-778-4258 Fax: 708-880-1239 |