Aunt Marthas Kankakee Community Health Center – Federally Qualified Health Center (FQHC), NPI 1790825347

Aunt Marthas Kankakee Community Health Center is a healthcare provider. based in Olympia fields, Illinois. specializing in Federally Qualified Health Center (FQHC). The organization holds a License No. 033 (IL). The NPI Number for Aunt Marthas Kankakee Community Health Center is 1790825347

Main info

Organization
Name
Aunt Marthas Kankakee Community Health Center
NPI
1790825347
Phone
(708) 747-7100
Address
19990 GOVERNORS HWY
Authorized Official
MR. CHRISTOPHER J NORDLOH CFO
Enumeration Date
6 February 2007
Last Update Date
21 July 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness80
Years active:19State licenses:1Digital endpointsUpdated within 12 months

Provider Addresses for Aunt Marthas Kankakee Community Health Center

  • 19990 GOVERNORS HWY

    OLYMPIA FIELDS, IL 604611021

    Phone: (708) 747-7100

    Type: Mailing

  • 1777 E COURT ST

    KANKAKEE, IL 609012670

    Phone: (708) 747-7100

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-07-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2026-02-28 (101 days ago).

Enrollment records

1

Earliest due date

2026-02-28

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20090710000496OFederally Qualified Health Center (Fqhc)IL2026-02-28

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60461)

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Reviews

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Frequently asked questions

Can I use this page to confirm Aunt Marthas Kankakee Community Health Center's NPI?
Yes. Aunt Marthas Kankakee Community Health Center is listed with NPI 1790825347 in the public NPI dataset.
Is Aunt Marthas Kankakee Community Health Center still practicing?
Aunt Marthas Kankakee Community Health Center is currently listed as active in the public NPI registry.
What taxonomy line describes Aunt Marthas Kankakee Community Health Center?
For research purposes, treat Aunt Marthas Kankakee Community Health Center as Federally Qualified Health Center (FQHC) in this dataset. Clinical services aligned with this taxonomy classification.
Where is Aunt Marthas Kankakee Community Health Center based?
Aunt Marthas Kankakee Community Health Center is tied to Olympia Fields, Illinois in the data we show; additional addresses may exist on the full record.
Why does Aunt Marthas Kankakee Community Health Center have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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