| Chestnut Health Systems, Inc | |
|
1003 Martin Luther King Dr Bloomington IL 61701-1429 | |
| (309) 826-6026 | |
| Not Available |
| Full Name | Chestnut Health Systems, Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1003 Martin Luther King Dr, Bloomington, 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 |
|---|---|
| Chestnut Health Systems, Inc 1003 Martin Luther King Dr Bloomington IL 61701-1429 Ph: () - | Chestnut Health Systems, Inc 1003 Martin Luther King Dr Bloomington IL 61701-1429 Ph: (309) 826-6026 |
| NPI Number | 1194227827 |
|---|---|
| Provider Enumeration Date | 03/08/2018 |
| Last Update Date | 03/16/2023 |
| Certification Date | 03/16/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194227827 | 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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