AUNT MARTHA'S YOUTH SERVICE CENTER, INC.
NPI 1780932061
Clinic/Center - Federally Qualified Health Center (FQHC) in Chicago, IL
NPI Status: Active since August 17, 2012
Contact Information
45 W 111TH ST
CHICAGO, IL
ZIP 60628
Phone: (877) 692-8686
Fax: (708) 747-8024
- Organization
- Clinic/Center
- Federally Qualified Health Center (FQHC)
- CLIA Number: 14D1029242
- CLIA Cert. Type: Federally Qualified Health Center
- CLIA Exp. Date: 08-11-2026
About AUNT MARTHA'S YOUTH SERVICE CENTER, INC.
This page provides the complete NPI Profile along with additional information for Aunt Martha's Youth Service Center, Inc., a primary care provider established in Chicago, Illinois operating as a Clinic/center, focusing in federally qualified health center (fqhc) . The healthcare provider is registered in the NPI registry with number 1780932061 assigned on August 2012. The practitioner's primary taxonomy code is 261QF0400X. The provider is registered as an organization and their NPI record was last updated 9 years ago. The authorized official of this NPI record is Audrey Pennington (Exec. Vp Of Health)
- NPI
- 1780932061
- Provider Name
- AUNT MARTHA'S YOUTH SERVICE CENTER, INC.
- Entity Type
- Organization
- Location Address
- 45 W 111TH ST CHICAGO, IL 60628
- Location Phone
- (877) 692-8686
- Location Fax
- (708) 747-8024
- Mailing Address
- 19990 GOVERNORS HWY OLYMPIA FIELDS, IL 60461
- Mailing Phone
- (708) 747-7100
- Mailing Fax
- (708) 747-8024
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-17-2012
- Last Update Date
- 11-02-2016
- Code Navigator
A primary care provider (PCP) like Aunt Martha's Youth Service Center, Inc. sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Federally Qualified Health Center (FQHC)
- Taxonomy Code
- 261QF0400X
- Type
- Ambulatory Health Care Facilities
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 14D1029242
- Facility Type
- Federally Qualified Health Center
- Certificate Effective Date
- August 12, 2024
- Certificate Expiration Date
- August 11, 2026
- Laboratory Director
- CHARLES BARRON M D
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Aunt Martha's Youth Service Center, Inc. in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 8 | 0 | 9 | 3 | 2 | 0 | 6 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 16 | 0 | 18 | 3 | 4 | 0 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 6 + 0 + 1 + 8 + 3 + 4 + 0 + 1 + 2 + 24 = 59 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 59 = 1 | 1 | ||||||||
The NPI number 1780932061 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1245222454 | CARL VANCOL MD Individual | Family Medicine | 45 W 111TH ST SUITE 304 CHICAGO, IL 60628 (773) 995-3463 |
| 1215979729 | DR. MADHUPA SUD M.D. Individual | Specialist | 45 W 111TH ST SUITE 203 CHICAGO, IL 60628 (773) 995-3460 |
| 1851328546 | NORYBDEER LIMITED Organization | Internal Medicine | 45 W 111TH ST SUITE B CHICAGO, IL 60628 (773) 370-5254 |
| 1356365233 | CLARETTA HODGES M.D. Individual | Anesthesiology | 45 W 111TH ST CHICAGO, IL 60628 (773) 995-3057 |
| 1700055571 | METROPOLITAN CHICAGO HEALTH ASSOCIATION Organization | General Practice | 45 W 111TH ST CHICAGO, IL 60628 (773) 995-3110 |
| 1659616142 | CHICAGO WOMENS HEALTH PRACTITIONER, LLC Organization | Obstetrics & Gynecology | 45 W 111TH ST 3RD FLOOR CHICAGO, IL 60628 (708) 468-4070 |
| 1063886760 | MADHUPA SUD MD SC Organization | Pediatrics | 45 W 111TH ST CHICAGO, IL 60628 (773) 995-3460 |
| 1619417979 | ROSELAND COMMUNITY HOSPITAL ASSOCIATION Organization | Pharmacy (Community/Retail Pharmacy) | 45 W 111TH ST CHICAGO, IL 60628 (773) 291-1684 |
| 1780110346 | ROXANNE SPURLARK Individual | Nurse Practitioner (Family) | 45 W 111TH ST CHICAGO, IL 60628 (773) 995-3000 |
| 1730687591 | TRANISHA LYNETTE LUCAS FNP-BC Individual | Nurse Practitioner (Family) | 45 W 111TH ST CHICAGO, IL 60628 (773) 995-3070 |
| 1063918555 | MRS. BRENDA BEBEN RD Individual | Dietitian, Registered | 45 W 111TH ST CHICAGO, IL 60628 (773) 995-3234 |
| 1265997142 | ROSELAND COMMUNITY HOSPITAL ASSOCIATION Organization | Dentist (General Practice) | 45 W 111TH ST CHICAGO, IL 60628 (773) 995-3000 |
| 1003371717 | SHAKIRA AYANLAJA APN Individual | Nurse Practitioner (Family) | 45 W 111TH ST CHICAGO, IL 60628 (773) 995-3195 |
| 1265481030 | EMERGENCY MEDICAL SPECIALIST, S.C Organization | Emergency Medicine | 45 W 111TH ST CHICAGO, IL 60628 (773) 995-3000 |
| 1922492628 | ADVANCED IMAGING SERVICES Organization | Radiology (Diagnostic Radiology) | 45 W 111TH ST CHICAGO, IL 60628 (630) 929-3034 |
| 1043816515 | NEW ROSE HEALTHCARE MANAGEMENT LLC Organization | Emergency Medicine | 45 W 111TH ST CHICAGO, IL 60628 (773) 995-3000 |
| 1740897149 | HEALTHCARE ALTERNATIVE SYSTEMS, INC. Organization | Clinic/Center (Rehabilitation, Substance Use Disorder) | 45 W 111TH ST CHICAGO, IL 60628 (773) 252-3100 |
| 1336229939 | DR. CARLITO CRUZ JAVIER MD Individual | Emergency Medicine | 45 W 111TH ST CHICAGO, IL 60628 (773) 995-3000 |
| 1851960876 | PANDEMIC SOLUTIONS LLC Organization | Anesthesiology (Pain Medicine) | 45 W 111TH ST CHICAGO, IL 60628 (312) 416-4363 |
| 1861121220 | JOHN DLABAL PA-C Individual | Physician Assistant | 45 W 111TH ST CHICAGO, IL 60628 (773) 995-3000 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1780932061, enumerated in the NPI registry as an "organization" on August 17, 2012
The provider is located at 45 W 111th St Chicago, Il 60628 and the phone number is (877) 692-8686
This medical organization specializes in Clinic/Center with taxonomy code 261QF0400X with a focus in Federally Qualified Health Center (FQHC)
The provider's CLIA number is 14D1029242 for a "federally qualified health center" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing..
This NPI record was last updated on August 17, 2012. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.