OrganizationActive
Aunt Martha'S Youth Service Center, Inc.
NPI 1104054386 · Federally Qualified Health Center (FQHC) · Hazel Crest, IL
Provider details
- NPI number
- 1104054386
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Christopher Nordloh, Cfo(708) 747-7100
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(85/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
17850 Kedzie Ave
Suite 3200
Hazel Crest, IL 60429-2058
Phone: (708) 335-5201
Street-level locationGet directions
Mailing address
19990 Governors Hwy
Olympia Fields, IL 60461-1021
Registry dates
- Enumerated
- 2009-06-26
- Last updated
- 2010-12-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.