NPIMap

Organization Active NPI

Chestnut Health Systems, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomington, IL
National Provider Identifier
1194227827
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
04023 Issued in IL
Legal business name
CHESTNUT HEALTH SYSTEMS, INC
Doing business as
Chestnut Health Systems, Inc
Practice address
1003 Martin Luther King Dr
Bloomington, IL 61701-1429
Phone
(309) 826-6026
NPI assigned
Mar 8, 2018
Organization subpart
Yes
Parent organization
CHESNTUT HEALTH SYSTEMS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Megan Marie Taylor
Title
Managed Care Supervisor
Phone
(888) 924-3786

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 04023 IL Primary

Addresses

Primary practice location

1003 Martin Luther King Dr
Bloomington, IL 61701-1429

Mailing address

1003 Martin Luther King Dr
Bloomington, IL 61701-1429

Other identifiers 1

IdentifierTypeStateIssuer
04023MedicaidIL

Other names 1

  • Chestnut Health Systems, Inc Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Chestnut Health Systems44 organizations share this tax ID, including this one
Part of
Chestnut Health Systems

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678924800000",
    "number": "1194227827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 MARTIN LUTHER KING DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617011429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 MARTIN LUTHER KING DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617011429",
            "telephone_number": "309-826-6026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESTNUT HEALTH SYSTEMS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHESNTUT HEALTH SYSTEMS, INC.",
        "enumeration_date": "2018-03-08",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "MANAGED CARE SUPERVISOR",
        "authorized_official_telephone_number": "888-924-3786"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IL",
            "license": "04023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04023",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chestnut Health Systems, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.