CHESTNUT HEALTH SYSTEMS, INC (NPI# 1194227827) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194227827 |
| Entity Type | Organization |
| Organization Name | CHESTNUT HEALTH SYSTEMS, INC |
| Other Organization Name | CHESTNUT HEALTH SYSTEMS, INC |
| Practice Address |
1003 Martin Luther King Dr Bloomington IL 61701-1429 |
| Practice Telephone | 3098266026 |
| Mailing Telephone | 3098266026 |
| Enumeration Date | 2018-03-08 |
| Last Update Date | 2018-10-02 |
| Authorized Official Name | MELISSA LYNN COOPER (MANAGED CARE SUPERVISOR) |
| Authorized Official Telephone | 3098203535 |
| Is Organization Subpart | Y |
| Parent Organization Name | CHESNTUT HEALTH SYSTEMS, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | Agencies | ||
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities | ||
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
04023 | IL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Chestnut Health Systems, Inc | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831634237 | Chestnut Health Systems, Inc | Clinic/Center | 12 N 64th St, Belleville, IL 62223-3809 | 2016-12-21 |
| 1326417080 | Chestnut Health Systems, Inc | Clinic/Center | 50 Northgate Industrial Dr, Granite City, IL 62040-6805 | 2015-09-23 |
| 1790055952 | Chestnut Health Systems, Inc | Clinic/Center | 702 W Chestnut St, Bloomington, IL 61701-2814 | 2012-01-05 |
| 1790083095 | Chestnut Health Systems, Inc | Case Management | 1425 6th St, Madison, IL 62060-1417 | 2011-03-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | CHESTNUT HEALTH SYSTEMS, INC. | 1003 Martin Luther King Drive, Bloomington, IL 61701 |
| Washington State Corporations | CHESTNUT HEALTH SYSTEMS, INC. | 1003 Martin Luther King Dr, Bloomington, IL 61701 |
| Indiana Business Entities | CHESTNUT HEALTH SYSTEMS, INC. | 1003 Martin Luther King Dr, Bloomington, IL 61701 |
| Street Address |
1003 MARTIN LUTHER KING DR |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61701-1429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366431686 | Chestnut Health Systems Inc | Substance Abuse Rehabilitation Facility | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 | 2005-10-19 |
| 1740889252 | Shelby Lynn Harvey | Counselor | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 | 2020-10-26 |
| 1821619545 | Matthew William Porzel | Counselor | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 | 2020-05-05 |
| 1669092482 | Angie Marie Lessen | Counselor | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 | 2020-04-22 |
| 1659905560 | Kristen Satchwell | Social Worker | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 | 2020-02-29 |
| 1952941676 | John Lorio | Social Worker | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 | 2020-01-10 |
| 1437792835 | Sehar Reshamwala | Counselor | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 | 2019-10-18 |
| 1760974737 | Brittany Cline | Counselor | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 | 2018-06-05 |
| 1740770742 | Jason Daniel Reel-haas | Counselor | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 | 2018-05-15 |
| 1831692078 | Lisa Kelly Jones | Counselor | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 | 2018-03-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770140964 | County of Mclean | Community/Behavioral Health | 200 W Front St, 1st Floor Sw, C/o 200 W Front St, Suite 400f, Bloomington, IL 61701 | 2019-05-22 |
| 1023525292 | Karli Johnson | Counselor | 200 W Monroe St Ste C7, Bloomington, IL 61701 | 2018-01-09 |
| 1487172409 | Melody Ann Bauman | Physician Assistant | 1505 Eastland Dr, Osf Critical Cane, Pulmonary, Sleep M, Bloomington, IL 61701 | 2017-08-30 |
| 1215396288 | Heidi Larsen | Social Worker | 902 S East St, Bloomington, IL 61701 | 2016-02-18 |
| 1558735126 | Andrea E. Andrews Counseling LLC | Counselor | 200 W. Monroe St., Ste 302 C, Bloomington, IL 61701 | 2015-11-19 |
| 1174924856 | Carole Hahn | Dietitian, Registered | 1406 Forrest St, Bloomington, IL 61701 | 2014-09-12 |
| 1558786392 | Valerie Colleen Parker | Counselor | 109 W. Mulberry St., Bloomington, IL 61701 | 2014-03-04 |
| 1124459219 | Matilde Francois | Surgery | 1505 Eastland Dr Ste 2300, Bloomington, IL 61701 | 2013-11-27 |
| 1922435114 | Smitha H Shivaprasad | Pharmacist | 2611 East Oakland Avenue, Bloomington, IL 61701 | 2013-10-02 |
| 1295161941 | Ashvin Patel | Obstetrics & Gynecology | 31 Country Club Pl, Bloomington, IL 61701 | 2013-09-25 |
| Find all providers in zip 61701 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083214159 | Amber Kinney, LLC | Clinic/Center | 623 S Washington St Apt A, Bloomington, IN 47401-5645 | 2020-10-28 |
| 1710585997 | Bloomington Neurofeedback | Clinic/Center | 1905 S Liberty Dr, Bloomington, IN 47403-5146 | 2020-10-11 |
| 1235744533 | Integrity Counseling, Inc. | Clinic/Center | 502 S Morris Ave Unit D, Bloomington, IL 61701-4891 | 2020-09-13 |
| 1326658568 | Jennifer Steinmetz Msw LLC | Clinic/Center | 115 N College Ave Ste 225, Bloomington, IN 47404-4099 | 2020-08-03 |
| 1376174904 | Karen Brosius LLC | Clinic/Center | 901 S Rogers St Ste 201, Bloomington, IN 47403-4760 | 2020-02-02 |
| 1023675634 | County of Mclean | Clinic/Center | 200 W Front St Ste 400e, Bloomington, IL 61701-5048 | 2019-05-20 |
| 1982175212 | Blue Skies Counseling LLC | Clinic/Center | 200 W Monroe St # 302a, Bloomington, IL 61701-3997 | 2018-12-16 |
| 1740705946 | Sea Glass Counseling, LLC | Clinic/Center | 2103 E Washington St Ste 2f, Bloomington, IL 61701-4365 | 2017-08-08 |
| 1164813671 | Inspiring Enterprises, LLC | Clinic/Center | 202 N Prospect Rd, Suite 207, Bloomington, IL 61704-7914 | 2015-02-05 |
| 1659761633 | Minnesota Counseling and Therapy Center | Clinic/Center | 140 W 98th St Ste 105, Bloomington, MN 55420-4800 | 2015-01-29 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 61701 |
Please comment or provide details below to improve the information on CHESTNUT HEALTH SYSTEMS, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.