CHESTNUT HEALTH SYSTEMS, INC.


Address: 648 State St Bldg B, Madison, IL 62060-1420
Phone: 6188777086

CHESTNUT HEALTH SYSTEMS, INC. (NPI# 1770850075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1770850075
Entity Type Organization
Organization Name CHESTNUT HEALTH SYSTEMS, INC.
Practice Address 648 State St Bldg B
Madison
IL 62060-1420
Mailing Address 648 State St
Bldg B
Madison
IL 62060-1420
Practice Telephone 6188777086
Practice Fax Number 6188779526
Mailing Telephone 6188777086
Mailing Fax Number 6188779526
Enumeration Date 2011-11-30
Last Update Date 2018-10-03
Authorized Official Name MELISSA LYNN COOPER (MANAGED CARE SUPERVISOR)
Authorized Official Telephone 3098203535
Authorized Official Credential LPN
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
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
N 320800000X Community Based Residential Treatment Facility, Mental Illness 04023 IL Residential Treatment Facilities
N 251B00000X Case Management 04023 IL Agencies
N 251S00000X Community/Behavioral Health 04023 IL Agencies
Y 261QM0801X Clinic/Center
Specialization: Mental Health (Including Community Mental Health Center)
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
MENTAL HEALTH LICENSE 04023 01

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1992179642 Chestnut Health Systems, Inc. Substance Abuse Rehabilitation Facility 110 Rottingham Ct, Suite B, Edwardsville, IL 62025-3788 2015-11-18
1902184054 Chestnut Health Systems, Inc. Clinic/Center 648 State St Bldg A, Madison, IL 62060-1420 2011-07-22
1194021485 Chestnut Health Systems, Inc. Case Management 732 S Illinois St, Belleville, IL 62220-2142 2011-02-03
1346566445 Chestnut Health Systems, Inc. Community Based Residential Treatment Facility, Mental Illness 814 Saint Louis Rd, Apt. 232, Collinsville, IL 62234-2023 2010-04-14
1245781079 Chestnut Health Systems, Inc. Substance Abuse Rehabilitation Facility 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 2016-10-17
1912371824 Chestnut Health Systems, Inc. Substance Abuse Rehabilitation Facility 370 Houbolt Rd, Suite 101, Joliet, IL 60431-8303 2015-11-17
1043587348 Chestnut Health Systems, Inc. Case Management 2148 Vadalabene Dr, Maryville, IL 62062-5632 2011-11-30
1003194150 Chestnut Health Systems, Inc. Clinic/Center 3924 Oakmont Dr, Pontoon Beach, IL 62040-4395 2011-07-22
1558649608 Chestnut Health Systems, Inc. Case Management 5109 N Illinois St, Apt. 101, Fairview Heights, IL 62208-3405 2011-07-22
1386922433 Chestnut Health Systems, Inc. Clinic/Center 1218 19th St, Granite City, IL 62040-4501 2011-07-22

Other Data Sources

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

Office Location

Street Address 648 STATE ST BLDG B
City MADISON
State IL
Zip Code 62060-1420

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1255514717 Southern Illinois Healthcare Foundation, Inc. Family Medicine 308 Madison Ave, Madison, IL 62060-1110 2007-12-07
1851305668 Jason F. Kesselring Pediatrics 304 Madison Ave, Madison, IL 62060-1110 2006-07-28
1376959668 Stay At Home Health Care Inc Home Health 1130 Douglas St, Madison, IL 62060-1122 2014-07-07
1174796734 Madison County Urban League Clinic/Center 500 Madison Ave, Madison, IL 62060-1414 2008-04-03
1740461870 Southern Illinois Healthcare Foundation, Inc. Family Medicine 1425 6th St, Madison, IL 62060-1417 2007-11-16
1790083095 Chestnut Health Systems, Inc Case Management 1425 6th St, Madison, IL 62060-1417 2011-03-10
1902184054 Chestnut Health Systems, Inc. Clinic/Center 648 State St Bldg A, Madison, IL 62060-1420 2011-07-22
1316126147 Southern Illinois Healthcare Foundation, Inc. Family Medicine 648 State St, Madison, IL 62060-1420 2007-10-29
1073936530 Kendra Jean Donaldson Social Worker 648 State St, Madison, IL 62060-1420 2014-02-03
1033310099 County of Madison Community Unit School Dist 12 Local Education Agency (LEA) 1707 4th St, Madison, IL 62060-1505 2007-05-29
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Taxonomy Information

Taxonomy Code 261QM0801X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Mental Health (Including Community Mental Health Center)

Taxonomy Definition

Definition to come...

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1861921553 Morristown Counseling Associates Clinic/Center 2 Green Village Rd Apt 203, Madison, NJ 07940-2581 2017-06-07
1689117202 Dr Christine Foskett LLC Clinic/Center 7633 Ganser Way Ste 104, Madison, WI 53719-2092 2016-11-30
1881044162 John Joseph Barisa Clinic/Center 209 Patricia Rd, Madison, AL 35758-1416 2016-06-16
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Competitor

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City MADISON
Zip Code 62060

Improve Information

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Dataset Information

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.

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