| Chestnut Health Systems, Inc. | |
|
648 State St Bldg B Madison IL 62060-1420 | |
| (618) 877-7086 | |
| (618) 877-9526 |
| Full Name | Chestnut Health Systems, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 648 State St Bldg B, Madison, 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. 648 State St Bldg B Madison IL 62060-1420 Ph: (618) 877-7086 |
| NPI Number | 1770850075 |
|---|---|
| Provider Enumeration Date | 11/30/2011 |
| Last Update Date | 03/16/2023 |
| Certification Date | 03/16/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770850075 | NPI | - | NPPES |
| 04023 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Chestnut Health Systems, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1425 6th St, Madison, IL 62060 Phone: 618-877-4420 Fax: 618-877-9526 | |
Chestnut Health Systems, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 648 State St Bldg A, Madison, IL 62060 Phone: 618-877-7086 |