Chestnut Health Systems, Inc – Federally Qualified Health Center (FQHC), NPI 1790055952
Federally Qualified Health Center (FQHC)
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Chestnut Health Systems, Inc
720 W CHESTNUT ST
BLOOMINGTON, IL 617012814
Phone: (309) 557-1400
Fax: (309) 557-1461
Type: Mailing
720 W Chestnut St
Bloomington, IL 617012814
Phone: (309) 557-1400
Fax: (309) 557-1461
Type: Location
1003 MARTIN LUTHER KING DR
BLOOMINGTON, IL 617011429
Phone:
Type: Mailing
702 W CHESTNUT ST
BLOOMINGTON, IL 617012814
Phone: (309) 557-1400
Fax: (309) 557-1461
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2012-11-08
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20121108000280 | O | Federally Qualified Health Center (Fqhc) | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 61701)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.