AUNT MARTHA'S WOODSTOCK COMMUNITY HEALTH CENTER – NPI #1912452483
Clinic/Center

AUNT MARTHA'S WOODSTOCK COMMUNITY HEALTH CENTER is an AHC clinic located in WOODSTOCK, IL. NPPES has assigned the NPI number 1912452483 to AUNT MARTHA'S WOODSTOCK COMMUNITY HEALTH CENTER on August 24, 2016. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “AUNT MARTHA'S WOODSTOCK COMMUNITY HEALTH CENTER” is a dba name, the actual legal business name for this organization is AUNT MARTHA'S YOUTH SERVICE CENTER. The primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was previously updated about 9 years ago on Jan 13, 2017. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for AUNT MARTHA'S WOODSTOCK COMMUNITY HEALTH CENTER below.

NPI Profile for
AUNT MARTHA'S YOUTH SERVICE CENTER

NPI Number
1912452483
Enumeration Date

(about 10 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
AUNT MARTHA'S YOUTH SERVICE CENTER
Doing Business As (dba): AUNT MARTHA'S WOODSTOCK COMMUNITY HEALTH CENTER
Primary location
3703 DOTY RD
MOB 1, SUITE 1
WOODSTOCK, IL 60098-7517
Phone: (877) 692-8686 Fax:
Mailing address
19990 GOVERNORS HWY
OLYMPIA FIELDS, IL 60461-1021
Phone: Fax:
Organization Subpart
No
Authorized Official
AUDREY PENNINGTON
EXECUTIVE VP OF HEALTH
Phone: (773) 802-7645
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.