CHESTNUT HEALTH SYSTEMS, INC (NPI# 1790083095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790083095 |
| Entity Type | Organization |
| Organization Name | CHESTNUT HEALTH SYSTEMS, INC |
| Practice Address |
1425 6th St Madison IL 62060-1417 |
| Mailing Address |
50 Northgate Industrial Dr Granite City IL 62040-6805 |
| Practice Telephone | 6188774420 |
| Practice Fax Number | 6188779526 |
| Mailing Telephone | 6188774420 |
| Mailing Fax Number | 6188779526 |
| Enumeration Date | 2011-03-10 |
| 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 | 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 | ||
| 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 |
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MENTAL HEALTH LICENSE | 04023 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194227827 | Chestnut Health Systems, Inc | Case Management | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 | 2018-03-08 |
| 1831634237 | Chestnut Health Systems, Inc | Clinic/Center | 12 N 64th St, Belleville, IL 62223-3809 | 2016-12-21 |
| 1326417080 | Chestnut Health Systems, Inc | Clinic/Center | 50 Northgate Industrial Dr, Granite City, IL 62040-6805 | 2015-09-23 |
| 1790055952 | Chestnut Health Systems, Inc | Clinic/Center | 702 W Chestnut St, Bloomington, IL 61701-2814 | 2012-01-05 |
| 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 |
| Indiana Business Entities | CHESTNUT HEALTH SYSTEMS, INC. | 1003 Martin Luther King Dr, Bloomington, IL 61701 |
| Street Address |
1425 6TH ST |
| City | MADISON |
| State | IL |
| Zip Code | 62060-1417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740461870 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 1425 6th St, Madison, IL 62060-1417 | 2007-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255514717 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 308 Madison Ave, Madison, IL 62060-1110 | 2007-12-07 |
| 1851305668 | Jason F. Kesselring | Pediatrics | 304 Madison Ave, Madison, IL 62060-1110 | 2006-07-28 |
| 1376959668 | Stay At Home Health Care Inc | Home Health | 1130 Douglas St, Madison, IL 62060-1122 | 2014-07-07 |
| 1174796734 | Madison County Urban League | Clinic/Center | 500 Madison Ave, Madison, IL 62060-1414 | 2008-04-03 |
| 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 |
| 1316126147 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 648 State St, Madison, IL 62060-1420 | 2007-10-29 |
| 1073936530 | Kendra Jean Donaldson | Social Worker | 648 State St, Madison, IL 62060-1420 | 2014-02-03 |
| 1033310099 | County of Madison Community Unit School Dist 12 | Local Education Agency (LEA) | 1707 4th St, Madison, IL 62060-1505 | 2007-05-29 |
| 1598248106 | Granite City Clinic Corp | Clinic/Center | 602 Farrish St, Madison, IL 62060-1567 | 2018-09-10 |
| Find all providers in zip 62060 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 1538712492 | Midtown Health Center, Inc. | Clinic/Center | 405 E 8th St, Madison, NE 68748-6319 | 2019-07-19 |
| 1023519956 | Strata Psychotherapy & Adhd Services, LLC | Clinic/Center | 6701 Seybold Rd Ste 114, Madison, WI 53719-1388 | 2018-02-26 |
| 1649785643 | Big Heart Counseling Center | Clinic/Center | 6409 Odana Rd Ste 24, Madison, WI 53719-1177 | 2017-12-12 |
| 1861921553 | Morristown Counseling Associates | Clinic/Center | 2 Green Village Rd Apt 203, Madison, NJ 07940-2581 | 2017-06-07 |
| 1689117202 | Dr Christine Foskett LLC | Clinic/Center | 7633 Ganser Way Ste 104, Madison, WI 53719-2092 | 2016-11-30 |
| 1881044162 | John Joseph Barisa | Clinic/Center | 209 Patricia Rd, Madison, AL 35758-1416 | 2016-06-16 |
| 1023261211 | The Family Resource Group | Clinic/Center | 313 Price Pl Ste 11, Madison, WI 53705-3250 | 2008-10-31 |
| Find all providers in MADISON | ||||
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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.