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Aunt Martha'S Youth Service Center — NPI 1174070676, Blue Island, IL | NPI Central

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NPI 1174070676

OrganizationActive

Aunt Martha'S Youth Service Center

NPI 1174070676 · Federally Qualified Health Center (FQHC) · Blue Island, IL

Provider details

NPI number: 1174070676
Entity type: Organization
Primary specialty: Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Organization subpart: No
Authorized official: Audrey Pennington, Executive Vp of Health(773) 802-7645

Specialties & taxonomies

Federally Qualified Health Center (FQHC)Primary261QF0400X
Ambulatory Health Care Facilities

Practice location

12139 S. Western Ave

Blue Island, IL 60406

Phone: (877) 692-8686

Approximate (ZIP-level) locationGet directions

More IL providers

Mailing address

19900 Governors Dr

Olympia Fields, IL 60461-1057

Other names (DBA / former)

Doing business as: Aunt Martha'S Blue Island Community Health Center

Registry dates

Enumerated: 2016-09-01
Last updated: 2017-01-13

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.