GATEWAY PROFESSIONAL SERVICES, PC (NPI# 1285272591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285272591 |
| Entity Type | Organization |
| Organization Name | GATEWAY PROFESSIONAL SERVICES, PC |
| Practice Address |
2200 Lake Victoria Dr Springfield IL 62703-5596 |
| Mailing Address |
55 E Jackson Blvd Ste 1500 Chicago IL 60604-4184 |
| Practice Telephone | 8773816538 |
| Mailing Telephone | 3126631130 |
| Mailing Fax Number | 3126630504 |
| Enumeration Date | 2019-12-17 |
| Last Update Date | 2019-12-19 |
| Authorized Official Name | DR. ROUEEN RAFEYAN (PRESIDENT) |
| Authorized Official Telephone | 3126631130 |
| Is Organization Subpart | Y |
| Parent Organization Name | GATEWAY PROFESSIONAL SERVICES, PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144855081 | Gateway Professional Services, PC | Counselor | 4028 Dempster St Unit 100, Skokie, IL 60076-2156 | 2020-03-11 |
| 1194363408 | Gateway Professional Services, PC | Counselor | 1 Bronze Pointe Blvd Ste 1, Swansea, IL 62226-1045 | 2019-12-17 |
| 1710528518 | Gateway Professional Services, PC | Counselor | 55 E Jackson Blvd Ste 1500, Chicago, IL 60604-4184 | 2019-10-02 |
| 1891333977 | Gateway Professional Services, PC | Counselor | 2323 Stevenson Dr, Springfield, IL 62703-4331 | 2019-12-19 |
| 1144868407 | Gateway Professional Services, PC | Counselor | 1300 Lincoln Ave, Jacksonville, IL 62650-3112 | 2019-12-18 |
| 1225676588 | Gateway Professional Services, PC | Counselor | 415 N Dearborn St Ste 510, Chicago, IL 60654-4659 | 2019-12-18 |
| 1497393839 | Gateway Professional Services, PC | Counselor | 1419 Essington Rd, Joliet, IL 60435-2873 | 2019-12-17 |
| 1306484621 | Gateway Professional Services, PC | Counselor | 222 S Greenleaf St, Gurnee, IL 60031-5705 | 2019-12-17 |
| 1194363564 | Gateway Professional Services, PC | Counselor | 25480 W Cedar Crest Ln, Lake Villa, IL 60046-9744 | 2019-12-17 |
| 1780222000 | Gateway Professional Services, PC | Counselor | 11 S Capitol St, Pekin, IL 61554-4106 | 2019-12-17 |
| Street Address |
2200 LAKE VICTORIA DR |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62703-5596 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326296856 | Gateway Foundation, Inc. | Clinic/Center | 2200 Lake Victoria Dr, Springfield, IL 62703-5596 | 2008-09-09 |
| 1841816741 | Stephanie Forgas | Counselor | 2200 Lake Victoria Dr, Springfield, IL 62703-5596 | 2020-06-17 |
| 1679115349 | David Bova | Counselor | 2200 Lake Victoria Dr, Springfield, IL 62703-5596 | 2019-10-14 |
| 1063988491 | Gina Howard | Counselor | 2200 Lake Victoria Dr, Springfield, IL 62703-5596 | 2018-10-24 |
| 1255807871 | Jennie Mccormick | Counselor | 2200 Lake Victoria Dr, Springfield, IL 62703-5596 | 2018-10-22 |
| 1518456607 | Thomas J Beck | Counselor | 2200 Lake Victoria Dr, Springfield, IL 62703-5596 | 2018-05-04 |
| 1841788932 | Joshua M Becker | Counselor | 2200 Lake Victoria Dr, Springfield, IL 62703-5596 | 2018-04-25 |
| 1093203093 | Denise L Skinner | Counselor | 2200 Lake Victoria Dr, Springfield, IL 62703-5596 | 2018-04-25 |
| 1699130856 | Gateway Foundation Inc. | Substance Abuse Rehabilitation Facility | 2200 Lake Victoria Dr, Springfield, IL 62703-5596 | 2015-12-15 |
| 1518346568 | Clayton Gerald Parks | Internal Medicine | 2200 Lake Victoria Dr, Springfield, IL 62703-5596 | 2015-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790260917 | Jessica Lynne Zeeck | Behavior Technician | 5220 6th Street Frontage Road, E Suite 1700, Springfield, IL 62703 | 2018-10-03 |
| 1215415799 | Bree Schmulbach | Nurse Practitioner | Bsb Room 20, Springfield, IL 62703 | 2018-08-06 |
| 1144712100 | Fresenius Medical Care Springfield East, LLC | Clinic/Center | 140 S. Martin Luther King Jr. Drive, Springfield, IL 62703 | 2018-06-05 |
| 1558889170 | Ji Woung Choi | Dentist | 687 E Linton Ave., Springfield, IL 62703 | 2017-09-04 |
| 1477006161 | Encompass Home Health of The Midwest,llc | Home Health | 2970 Baker Dr, Springfield, IL 62703 | 2016-07-28 |
| 1851706824 | Terah Louise Holland | Obstetrics & Gynecology | 1100 E Lincolnshire Blvd Ste 200, Springfield, IL 62703 | 2014-06-27 |
| 1578993101 | Corey Moore | Behavioral Analyst | 5520 South 6th Street Road, Suite 1700, Springfield, IL 62703 | 2013-11-18 |
| 1134463052 | The Center for Youth and Family Solutions Inc. | Voluntary or Charitable | 614 North Sixth Street, Springfield, IL 62703 | 2012-11-15 |
| 1447519111 | Tenshi Furumi | Specialist/Technologist | One University Plaza, Univ. of Illinois-springfield, Ms Rec 2004, Springfield, IL 62703 | 2012-05-15 |
| 1447558390 | Shalini Mulkanoor | Family Medicine | 1100 E. Lincolnshire Blvd., Suite 200, Springfield, IL 62703 | 2011-03-02 |
| Find all providers in zip 62703 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649803990 | Stephanie R Stephens | Counselor | 1705 Maiden Ln, Springfield, OH 45504-2908 | 2020-02-14 |
| 1801449988 | Maurice Steven Martinez | Counselor | 7215 Adrienne Glen Ave, Springfield, VA 22152-3540 | 2019-07-18 |
| 1215494737 | John Henry Mccollum Jr. | Counselor | 80 Congress St Ste 101, Springfield, MA 01104-3427 | 2019-02-21 |
| 1821584541 | Patricia Thakur | Counselor | 404 E Battlefield St # R, Springfield, MO 65807-4802 | 2018-07-05 |
| 1336632074 | Solutions Group Nw LLC | Counselor | 3831 Main St Ste 108, Springfield, OR 97478-5801 | 2018-06-07 |
| 1285126235 | Rebecca Ann Dalton | Counselor | 3032 S Fremont Ave Ste C200, Springfield, MO 65804-4210 | 2018-06-05 |
| 1184136905 | Mark Jones | Counselor | 120 N Fountain Ave, Springfield, OH 45502-1163 | 2017-11-02 |
| 1457863599 | Michael A Carter | Counselor | 832 Olive St, Springfield, OH 45503-3738 | 2017-10-30 |
| 1710498001 | Springfield Treatment Center | Counselor | 1485 Market St, Springfield, OR 97477-3337 | 2017-10-13 |
| 1740702547 | Domingo Nieves Jr. | Counselor | 2225 Main St., Springfield, MA 01107 | 2017-07-13 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62703 |
Please comment or provide details below to improve the information on GATEWAY PROFESSIONAL SERVICES, PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.