Chestnut Health Systems

NPI 1114351947 - Clinic/Center - 261QM0801X

NPI Details
NPI 1114351947
Enumeration Date 08/28/2013
Last Updated 08/28/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name DIETRA DIETRA
Position EXECUTIVE DIRECTOR
Phone (309) 557-1400
Fax
Practice Location
702 W CHESTNUT ST
BLOOMINGTON IL, 61701-2814, US
Phone (309) 557-1400
Fax
Business Location
702 W CHESTNUT ST
BLOOMINGTON IL, 61701-2814, US
Phone (309) 557-1400
Fax
Toxanomy
Taxonomy Code 261QM0801X
License State Illinois
License Number 04023
Remove 1114351947 NPI Number
 

According to our database, Chestnut Health Systems NPI is 1114351947, taxonomy code is 261QM0801X and license number is 04023, license state is located at Illinois. Chestnut Health Systems physically located at 702 W Chestnut St, Bloomington IL, 61701-2814. NPI Number 1033115704 has the healthcare provider type.

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1114351947 NPI number is provided on an as is basis without warranty of any kind. 1114351947 is maintained by the National Plan & Provider Enumeration System. The contents of Chestnut Health Systems are for informational purposes only.