Organization
CHESTNUT HEALTH SYSTEMS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEGAN M TAYLOR (REVENUE CREDENTIALING SPECIALIST)
(186) 512-1803
Entity
Organization
Contact information
Practice address
2148 VADALABENE DR, MARYVILLE, IL 62062-5632
(618) 877-4420
Mailing address
1003 MARTIN LUTHER KING DR, BLOOMINGTON, IL 61701-1429
(888) 924-3786
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A-0126-0006-A
—
IL
Enumeration date
07/07/2023
Last updated
07/07/2023
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