Chestnut Health Systems Inc | |
702 W Chestnut St Bloomington IL 61701-2814 | |
(309) 557-1400 | |
(309) 557-1461 |
Full Name | Chestnut Health Systems Inc |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 702 W Chestnut St, Bloomington, Illinois |
Authorized Official Name and Position | Puneet Leekha (CHIEF OPERATING OFFICER) |
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 448 Wylie Dr Normal IL 61761-5405 Ph: (888) 924-3786 | Chestnut Health Systems Inc 702 W Chestnut St Bloomington IL 61701-2814 Ph: (309) 557-1400 |
NPI Number | 1447854427 |
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Provider Enumeration Date | 11/30/2020 |
Last Update Date | 11/30/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447854427 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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