Chestnut Health Systems, Inc. | |
12 N 64th St Belleville IL 62223-3809 | |
(618) 397-0900 | |
(618) 397-0093 |
Full Name | Chestnut Health Systems, Inc. |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 12 N 64th St, Belleville, Illinois |
Authorized Official Name and Position | Megan Marie Taylor (MANAGED CARE SUPERVISOR) |
Authorized Official Contact | 8889243786 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Chestnut Health Systems, Inc. 1003 Martin Luther King Dr Bloomington IL 61701-1429 Ph: () - | Chestnut Health Systems, Inc. 12 N 64th St Belleville IL 62223-3809 Ph: (618) 397-0900 |
NPI Number | 1760602593 |
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Provider Enumeration Date | 04/26/2007 |
Last Update Date | 03/16/2023 |
Certification Date | 03/16/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1760602593 | NPI | - | NPPES |
04023 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 04023 (Illinois) | Primary |
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