Organization
CHESTNUT HEALTH SYSTEMS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIETRA KULICKE (EXECUTIVE DIRECTOR OF CFHC)
(309) 557-1437
Entity
Organization
Contact information
Practice address
12 N 64TH ST, BELLEVILLE, IL 62223-3809
(618) 397-0900
(618) 397-0093
Mailing address
1003 MARTIN LUTHER KING DR, BLOOMINGTON, IL 61701-1429
(309) 827-6026
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/21/2016
Last updated
01/30/2017
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