NPIMap

Organization Active NPI

Chestnut Health Systems Inc.

  • Substance Abuse Rehabilitation Facility
  • Maryville, IL
National Provider Identifier
1609554815
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
CHESTNUT HEALTH SYSTEMS INC.
Practice address
2148 Vadalabene Dr
Maryville, IL 62062-5632
Phone
(618) 877-4420
NPI assigned
Jul 7, 2023
Last updated
Jul 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Authorized official

Name
Megan M Taylor
Title
Revenue Credentialing Specialist
Phone
(618) 512-1803

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

2148 Vadalabene Dr
Maryville, IL 62062-5632

Mailing address

1003 Martin Luther King Dr
Bloomington, IL 61701-1429
Phone (888) 924-3786

Other identifiers 1

IdentifierTypeStateIssuer
A-0126-0017-AMedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Chestnut Health Systems44 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

NPI Registry JSON

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

{
    "created_epoch": "1688688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690329600000",
    "number": "1609554815",
    "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",
            "telephone_number": "888-924-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2148 VADALABENE DR",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625632",
            "telephone_number": "618-877-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESTNUT HEALTH SYSTEMS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-07",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "REVENUE CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "618-512-1803"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A-0126-0017-A",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.