| Chestnut Family Health Center | |
|
1003 Martin Luther King Dr Bloomington IL 61701-1429 | |
| (888) 924-3678 | |
| Not Available |
| Full Name | Chestnut Family Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1003 Martin Luther King Dr, Bloomington, Illinois |
| Authorized Official Name and Position | Megan Marie Taylor (MANAGED CARE SUPERVISOR) |
| Authorized Official Contact | 8889243786 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chestnut Family Health Center 1003 Martin Luther King Dr Bloomington IL 61701-1429 | Chestnut Family Health Center 1003 Martin Luther King Dr Bloomington IL 61701-1429 Ph: (888) 924-3678 |
| NPI Number | 1225740756 |
|---|---|
| Provider Enumeration Date | 12/15/2022 |
| Last Update Date | 03/16/2023 |
| Certification Date | 03/16/2023 |
| Medicare PECOS PAC ID | 1052393063 |
|---|---|
| Medicare Enrollment ID | O20230302001846 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225740756 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (NU) | Primary |
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