CHESTNUT HEALTH SYSTEMS INC (NPI# 1609144815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609144815 |
| Entity Type | Organization |
| Organization Name | CHESTNUT HEALTH SYSTEMS INC |
| Practice Address |
50 Northgate Industrial Dr Granite City IL 62040 |
| Mailing Address |
1003 Martin Luther King Dr Bloomington IL 61701 |
| Practice Telephone | 6188774420 |
| Practice Fax Number | 6188770904 |
| Mailing Telephone | 3098203535 |
| Mailing Fax Number | 3098203574 |
| Enumeration Date | 2011-12-02 |
| Last Update Date | 2018-10-25 |
| Authorized Official Name | MELISSA 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 | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 324500000X | Substance Abuse Rehabilitation Facility | A-0126-0001-A | IL | Residential Treatment Facilities |
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | C/A-0126-0001-A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619921665 | Chestnut Health Systems Inc | Community Based Residential Treatment Facility, Mental Illness | 50 Northgate Industrial Dr, Granite City, IL 62040-6805 | 2006-05-22 |
| 1366431686 | Chestnut Health Systems Inc | Substance Abuse Rehabilitation Facility | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 | 2005-10-19 |
| 1578197877 | Chestnut Health Systems Inc | Clinic/Center | 1419 S Folkers Ave, Peoria, IL 61605-1391 | 2020-02-25 |
| 1114351947 | Chestnut Health Systems Inc | Clinic/Center | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 | 2013-08-28 |
| 1700154911 | Chestnut Health Systems Inc | Substance Abuse Rehabilitation Facility | 12 N 64th St, Belleville, IL 62223 | 2011-12-02 |
| 1356596563 | Chestnut Health Systems Inc | Community/Behavioral Health | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 | 2008-12-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Chestnut Health Systems Inc. | 1003 Martin Luther King Dr, Bloomington, Illinois 61701 |
| Street Address |
50 NORTHGATE INDUSTRIAL DR |
| City | GRANITE CITY |
| State | IL |
| Zip Code | 62040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619921665 | Chestnut Health Systems Inc | Community Based Residential Treatment Facility, Mental Illness | 50 Northgate Industrial Dr, Granite City, IL 62040-6805 | 2006-05-22 |
| 1881207884 | Laura Beth Marcum | Social Worker | 50 Northgate Industrial Dr, Granite City, IL 62040-6805 | 2020-08-28 |
| 1063023943 | Min Shin | Social Worker | 50 Northgate Industrial Dr, Granite City, IL 62040-6805 | 2020-08-13 |
| 1184244261 | Lisa M Saunders | Social Worker | 50 Northgate Industrial Dr, Granite City, IL 62040-6805 | 2020-04-20 |
| 1487280616 | Haley Staats | Counselor | 50 Northgate Industrial Dr, Granite City, IL 62040-6805 | 2020-03-19 |
| 1861027724 | Anne Marie Calvert | Counselor | 50 Northgate Industrial Dr, Granite City, IL 62040-6805 | 2020-03-11 |
| 1447883954 | Lori Epley | Social Worker | 50 Northgate Industrial Dr, Granite City, IL 62040-6805 | 2020-02-13 |
| 1487286720 | John Ritcheson | Counselor | 50 Northgate Industrial Dr, Granite City, IL 62040-6805 | 2020-02-05 |
| 1235779208 | Candyce Hurd | Counselor | 50 Northgate Industrial Dr, Granite City, IL 62040-6805 | 2020-01-08 |
| 1841838737 | Kate E Timmermann | Social Worker | 50 Northgate Industrial Dr, Granite City, IL 62040-6805 | 2019-12-11 |
| Find all providers in the same location | ||||
| 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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| 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.