GATEWAY PROFESSIONAL SERVICES, PC (NPI# 1790323186) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790323186 |
| Entity Type | Organization |
| Organization Name | GATEWAY PROFESSIONAL SERVICES, PC |
| Practice Address |
3828 W Taylor St Chicago IL 60624-4027 |
| Mailing Address |
55 E Jackson Blvd Ste 1500 Chicago IL 60604-4184 |
| Practice Telephone | 8773816538 |
| Mailing Telephone | 3126631130 |
| Mailing Fax Number | 3126630504 |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2019-12-19 |
| Authorized Official Name | 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 |
3828 W TAYLOR ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60624-4027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790970689 | Stacy April Lott | Student in an Organized Health Care Education/Training Program | 3828 W Taylor St, Chicago, IL 60624-4027 | 2007-09-13 |
| 1205306560 | Aida Jusufovic | Counselor | 3828 W Taylor St, Chicago, IL 60624-4027 | 2018-11-29 |
| 1710455704 | Kerren Lloyd | Counselor | 3828 W Taylor St, Chicago, IL 60624-4027 | 2018-11-07 |
| 1982171922 | Michael Mahoney | Counselor | 3828 W Taylor St, Chicago, IL 60624-4027 | 2018-10-29 |
| 1013484070 | Ruben Morales | Counselor | 3828 W Taylor St, Chicago, IL 60624-4027 | 2018-10-29 |
| 1730654880 | Brenda Brown | Counselor | 3828 W Taylor St, Chicago, IL 60624-4027 | 2018-10-04 |
| 1801379771 | Angela Osting | Counselor | 3828 W Taylor St, Chicago, IL 60624-4027 | 2018-09-07 |
| 1326520420 | Gilbert Lichstein | Counselor | 3828 W Taylor St, Chicago, IL 60624-4027 | 2018-09-05 |
| 1063900926 | Tanika C Cook | Counselor | 3828 W Taylor St, Chicago, IL 60624-4027 | 2018-04-26 |
| 1124516083 | Carli M Hornik | Counselor | 3828 W Taylor St, Chicago, IL 60624-4027 | 2018-04-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669071932 | Euginia Ivanova | Counselor | 3410 W. Roosevelt Rd, Chicago, IL 60624 | 2020-10-19 |
| 1629619572 | Denise R Bean | Technician | 3322 West Polk St, Chicago, IL 60624 | 2019-10-02 |
| 1033693742 | Ahmed Hussain Memon | Nurse Practitioner | 3800 West Madison, Chicago, IL 60624 | 2018-09-18 |
| 1487104006 | Jeffrey Blythe | Social Worker | 3605 W. Fillmore Street, Ucan, Chicago, IL 60624 | 2016-10-06 |
| 1366992216 | Brian Macwilliams | Social Worker | 3605 W. Fillmore St, Chicago, IL 60624 | 2016-10-04 |
| 1982151510 | Darryl Lamont Clayton | Counselor | 3605 W. Fillmore, Chicago, IL 60624 | 2016-09-01 |
| 1821487646 | Total Enrichment Services Inc. | Counselor | 3335 W Washington Blvd, Chicago, IL 60624 | 2015-01-16 |
| 1295038818 | Raad N Rashan M D S C | Internal Medicine | 3743 W Chicago Ave, Chicago, IL 60624 | 2010-12-21 |
| 1194044453 | Theresa Roberts | Speech-Language Pathologist | 3240 W. Franklin Blvd, Chicago, IL 60624 | 2010-05-26 |
| 1154570208 | Ht Outpatient Pharmacy | Pharmacy | 3435 W Vanburen St, Chicago, IL 60624 | 2008-09-13 |
| Find all providers in zip 60624 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669071932 | Euginia Ivanova | Counselor | 3410 W. Roosevelt Rd, Chicago, IL 60624 | 2020-10-19 |
| 1073127775 | Deborah Lynn Dettman | Counselor | 1209 W Sherwin Ave Apt 809, Chicago, IL 60626-2257 | 2020-09-01 |
| 1538705793 | Andrew W Rintels | Counselor | C/o Madden, Jiganti, Moore & Sinars LLP, 190 South Lasalle Street, Suite 1700, Chicago, IL 60603 | 2019-11-22 |
| 1710528518 | Gateway Professional Services, PC | Counselor | 55 E Jackson Blvd Ste 1500, Chicago, IL 60604-4184 | 2019-10-02 |
| 1801447552 | Erika Chawla | Counselor | 1658 N Milwaukee Ave # 8253, Chicago, IL 60647-6905 | 2019-09-24 |
| 1336790310 | Robert J Smith | Counselor | 2544 W Irving Park Rd Apt 1e, Chicago, IL 60618-3752 | 2019-09-22 |
| 1255997987 | Austin Hall | Counselor | 2942 W Lake St, Chicago, IL 60612-1924 | 2019-05-17 |
| 1417418914 | Monica Connelly | Counselor | 800 N Lake Shore Dr Ste 800, Chicago, IL 60611-2402 | 2019-03-27 |
| 1336608439 | Columbus Manor | Counselor | 5107 W Jackson Blvd, Chicago, IL 60644-4316 | 2019-03-18 |
| 1972062958 | Patricia B Flaherty | Counselor | 210 S Desplaines St Apt 1407, Chicago, IL 60661-5570 | 2019-03-18 |
| Find all providers in CHICAGO | ||||
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| 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.