| Chestnut Family Health Center | |
|
702 W Chestnut St Bloomington IL 61701-2814 | |
| (309) 557-1400 | |
| (309) 557-1461 |
| Full Name | Chestnut Family Health Center |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 702 W Chestnut St, Bloomington, Illinois |
| Authorized Official Name and Position | Puneet Leekha (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 8889243786 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chestnut Family Health Center 448 Wylie Dr Normal IL 61761-5405 Ph: (888) 924-3786 | Chestnut Family Health Center 702 W Chestnut St Bloomington IL 61701-2814 Ph: (309) 557-1400 |
| NPI Number | 1447854427 |
|---|---|
| Provider Enumeration Date | 11/30/2020 |
| Last Update Date | 11/30/2020 |
| Certification Date | 11/19/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447854427 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | () | Primary |
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