Healthcare Provider Details

I. General information

NPI: 1205907763
Provider Name (Legal Business Name): CHESTNUT GLOBAL PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 MARTIN LUTHER KING DR
BLOOMINGTON IL
61701-1429
US

IV. Provider business mailing address

1003 MARTIN LUTHER KING DR
BLOOMINGTON IL
61701-1429
US

V. Phone/Fax

Practice location:
  • Phone: 309-827-6026
  • Fax: 309-820-3574
Mailing address:
  • Phone: 309-827-6026
  • Fax: 309-820-3574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: DAVE SHARAR
Title or Position: MANAGING PARTNER
Credential: MPA
Phone: 309-827-6026