MEDICARE: AUNT MARTHA'S YOUTH SERVICE CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1538339411
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUNT MARTHA'S YOUTH SERVICE CENTER INC

Provider Business Mailing Address
First Line	:	19990 GOVERNORS HWY
Second Line	:
City	:	OLYMPIA FIELDS
State	:	IL
Zip	:	60461-1021
Country	:	US
Telephone Number	:	708-747-7100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1777 E COURT ST
Second Line	:
City	:	KANKAKEE
State	:	IL
Zip	:	60901-2670
Country	:	US
Telephone Number	:	815-937-0100
Fax Number	:	815-937-1823

Authorized Official
Title or Position	:	CFO
Name	:	MR. CHRISTOPHER J NORDLOH
Credential	:
Telephone Number	:	708-747-7100

Provider Enumeration Date	:	03/06/2008
Last Update Date	:	12/02/2010

Similar Medicare Providers

1760485007 — DR. OLATUNJI R AKINTILO M.D.
Practice Location Address:

1701 E COURT ST
KANKAKEE, IL
60901-2670

Practice Phone: 815-935-9394
Practice Fax: 815-935-1187

1104925692 — JUDITH D MAGDZIARZ NP
Practice Location Address:

1701 E COURT ST
KANKAKEE, IL
60901-2670

Practice Phone: 815-935-9395
Practice Fax: 815-935-1187

1790825347 — AUNT MARTHAS YOUTH SERVICE CENTER INC
Practice Location Address:

1777 E COURT ST
KANKAKEE, IL
60901-2670

Practice Phone: 708-747-7100
Practice Fax:

1972705192 — AUNT MARTHA'S YOUTH SERVICE CENTER
Practice Location Address:

1777 E COURT ST , LOWER LEVEL
KANKAKEE, IL
60901-2670

Practice Phone: 815-937-5413
Practice Fax:

1396070520 — AUNT MARTHA'S YOUTH SERVICE CENTER INC
Practice Location Address:

1777 E COURT ST
KANKAKEE, IL
60901-2670

Practice Phone: 815-937-0100
Practice Fax: 815-937-1823

1912260407 — MRS. TANYA MARIA RICHARDSON-BELGRAVE CNP
Practice Location Address:

1701 E COURT ST
KANKAKEE, IL
60901-2670

Practice Phone: 815-935-9394
Practice Fax:

Directions to “AUNT MARTHA'S YOUTH SERVICE CENTER INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.