Organization
CHESTNUT HEALTH SYSTEMS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEGAN MARIE TAYLOR (MANAGED CARE SUPERVISOR)
(888) 924-3786
Entity
Organization
Contact information
Practice address
1003 MARTIN LUTHER KING DR, BLOOMINGTON, IL 61701-1429
(309) 827-6026
(309) 820-1386
Mailing address
1003 MARTIN LUTHER KING DR, BLOOMINGTON, IL 61701-1429
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04023
—
IL
05
—
C/A-0126-0007-A
—
IL
Enumeration date
10/19/2005
Last updated
03/16/2023
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