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
50 NORTHGATE INDUSTRIAL DR, GRANITE CITY, IL 62040
(618) 877-4420
(618) 877-0904
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)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
A-0126-0001-A
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
C/A-0126-0001-A
—
IL
Enumeration date
12/02/2011
Last updated
03/16/2023
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