CHESTNUT HEALTH SYSTEMS, INC. (NPI# 1386922433) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1386922433 |
Entity Type | Organization |
Organization Name | CHESTNUT HEALTH SYSTEMS, INC. |
Practice Address |
1218 19th St Granite City IL 62040-4501 |
Mailing Address |
1003 Martin Luther King Dr Bloomington IL 61701-1429 |
Practice Telephone | 6184522768 |
Mailing Telephone | 3098276026 |
Mailing Fax Number | 3098203574 |
Enumeration Date | 2011-07-22 |
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
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 |
N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MENTAL HEALTH LICENSE | 04023 | 01 | |
IL | MENTAL HEALTH LICENSE | 04023 | 01 |
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 |
1770850075 | Chestnut Health Systems, Inc. | Clinic/Center | 648 State St Bldg B, Madison, IL 62060-1420 | 2011-11-30 |
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 |
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 |
Street Address |
1218 19TH ST |
City | GRANITE CITY |
State | IL |
Zip Code | 62040-4501 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023299153 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 1218 19th St, Granite City, IL 62040-4501 | 2007-11-16 |
1548640162 | Eric Johnson | Social Worker | 1218 19th St, Granite City, IL 62040-4501 | 2015-06-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043736705 | Christine S Bieniecki Canada | Speech-Language Pathologist | 2300 West 25th St, Granite City, IL 62040 | 2017-08-15 |
1881085819 | James Watson | Counselor | 50 Northgate Industrial Drive, Granite City, IL 62040 | 2015-02-12 |
1518208719 | Chestnut Health Systems | Clinic/Center | 110 Northagte Industrial Drive, Granite City, IL 62040 | 2013-03-13 |
1952651697 | Victor Manuel Pinones | Dentist | 2130 Johnson Rd., Granite City, IL 62040 | 2012-09-10 |
1427360502 | Erin K Boerm | Occupational Therapist | 3540 Village Lane, Granite City, IL 62040 | 2010-07-06 |
1659503027 | Toni Lyn Siler | Counselor | 101 Whitsell Way, Apt 102, Pontoon Beach, IL 62040 | 2009-08-18 |
1871741462 | Fountain View Manor LLC | Alzheimer Center (Dementia Center) | 3432 Village Lane, Granite City, IL 62040 | 2008-09-08 |
1083880595 | Christina Marie Darin | Chiropractor | 2013 Johnson Road, Suite C & D, Granite City, IL 62040 | 2008-05-05 |
1629244322 | Julia Elaine Uhring Green | Counselor | 2429 Washinton Ave, Granite City, IL 62040 | 2008-05-02 |
1578786117 | John K Parker | Preventive Medicine | Veeder Health Center, 20th and Iowa, Granite City, IL 62040 | 2007-04-11 |
Find all providers in zip 62040 |
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 |
---|---|---|---|---|
1134311038 | Children's Home & Aid Society of Il | Clinic/Center | 2133 Johnson Rd, Granite City, IL 62040-3986 | 2007-08-14 |
1134612054 | Good Samaritan House of Granite City, Inc | Clinic/Center | 1825 Delmar Ave, Granite City, IL 62040-4508 | 2018-06-14 |
1013269984 | Granite City Psychiatry LLC | Clinic/Center | 2120 Madison Ave, Suite 405, Granite City, IL 62040-4744 | 2012-10-02 |
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1346840295 | Stopka Professional Counseling LLC | Clinic/Center | 13125 Steeplechase Dr, New Lenox, IL 60451-1320 | 2020-10-29 |
1346848785 | Wellness Hearted Therapy LLC | Clinic/Center | 2675 S Cedar Glen Dr, Arlington Heights, IL 60005-5303 | 2020-10-16 |
1457959256 | Association for Individual Development | Clinic/Center | 708 N Bridge St, Yorkville, IL 60560-1105 | 2020-10-14 |
1285231555 | Association for Individual Development | Clinic/Center | 236 W Crystal Lake Ave, Crystal Lake, IL 60014-5847 | 2020-10-08 |
1386241123 | Envision Unlimited | Clinic/Center | 1801 N Spaulding Ave, Chicago, IL 60647-4926 | 2020-10-05 |
1881291789 | Jessica Weisbach, LLC | Clinic/Center | 2257 N Kedzie Blvd Apt 3, Chicago, IL 60647-2561 | 2020-10-04 |
1619574803 | Envision Unlimited | Clinic/Center | 2124 W 82nd Pl, Chicago, IL 60620-5358 | 2020-10-01 |
1144827320 | Envision Unlimited | Clinic/Center | 4919 N Clark St, Chicago, IL 60640-3514 | 2020-10-01 |
1194322370 | Envision Unlimited | Clinic/Center | 4911 S Hoyne Ave, Chicago, IL 60609-4721 | 2020-10-01 |
Find all providers with the same taxonomy |
City | GRANITE CITY |
Zip Code | 62040 |
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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.