CHESTNUT HEALTH SYSTEMS NPI 1801069059

NPI Information

NPI: 1801069059
Provider Name: CHESTNUT HEALTH SYSTEMS
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
2148 VADALABENE DR
MARYVILLE, IL
ZIP 62062
Phone: (618) 288-3100
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CHESTNUT HEALTH SYSTEMS is a substance abuse rehabilitation facility in Maryville, IL. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. CHESTNUT HEALTH SYSTEMS NPI is 1801069059. The provider is registered as an organization entity type.

The provider's business location address is:

2148 VADALABENE DR
MARYVILLE, IL
ZIP 62062-632
Phone: (618) 288-3100
Fax: (618) 288-2278

The provider's authorized official is Megan Marie Taylor .
The authorized official title is Managed Care Supervisor and has the following contact phone number (888) 924-3786.

The enumeration date for this NPI number is 4/9/2008 and was last updated on 3/16/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			No
2	3245S0500X	Substance Abuse Rehabilitation Facility	Substance Abuse Treatment, Children	0126-0006	ILLINOIS	No
3	324500000X	Substance Abuse Rehabilitation Facility				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	C/A 0126-0006-A	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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