| Chestnut Family Health Center | |
|
702 W Chestnut St Bloomington IL 61701-2814 | |
| (309) 557-1400 | |
| (309) 557-1461 |
| Full Name | Chestnut Family Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 702 W Chestnut St, Bloomington, Illinois |
| Authorized Official Name and Position | Megan Marie Taylor (MANAGED CARE SUPERVISOR) |
| Authorized Official Contact | 8889243786 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chestnut Family Health Center 1003 Martin Luther King Dr Bloomington IL 61701-1429 Ph: () - | Chestnut Family Health Center 702 W Chestnut St Bloomington IL 61701-2814 Ph: (309) 557-1400 |
| NPI Number | 1790055952 |
|---|---|
| Provider Enumeration Date | 01/05/2012 |
| Last Update Date | 03/16/2023 |
| Medicare PECOS PAC ID | 1052393063 |
|---|---|
| Medicare Enrollment ID | O20121108000280 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790055952 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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