Organization Active NPI

Chestnut Health Systems Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Peoria, IL
National Provider Identifier
1578197877
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
CHESTNUT HEALTH SYSTEMS INC
Practice address
1419 S Folkers Ave
Peoria, IL 61605-1391
Phone
(888) 924-3786
NPI assigned
Feb 25, 2020
Last updated
Mar 16, 2023By the provider in NPPES
Organization subpart
No

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
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary

Addresses

Primary practice location

1419 S Folkers Ave
Peoria, IL 61605-1391

Mailing address

1003 Martin Luther King Dr
Bloomington, IL 61701-1429

Other identifiers 1

IdentifierTypeStateIssuer
A-0126-0016-AMedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Chestnut Health Systems Inc44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

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

View all 43

Locations

1419 S Folkers Ave
Peoria, IL 61605
Phone (309) 676-7803

NPI Registry JSON

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

{
    "created_epoch": "1582588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678924800000",
    "number": "1578197877",
    "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": "1419 S FOLKERS AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616051391",
            "telephone_number": "888-924-3786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESTNUT HEALTH SYSTEMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-25",
        "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": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A-0126-0016-A",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, 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.