GATEWAY PROFESSIONAL SERVICES PC NPI 1144868407

NPI Information

NPI: 1144868407
Provider Name: GATEWAY PROFESSIONAL SERVICES, PC
Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
1300 LINCOLN AVE
JACKSONVILLE, IL
ZIP 62650
Phone: (877) 381-6538
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GATEWAY PROFESSIONAL SERVICES, PC is an addiction (substance use disorder) counselor in Jacksonville, IL. GATEWAY PROFESSIONAL SERVICES, PC NPI is 1144868407. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1300 LINCOLN AVE
JACKSONVILLE, IL
ZIP 62650-112
Phone: (877) 381-6538

The provider's authorized official is Roueen Rafeyan .
The authorized official title is President and has the following contact phone number (312) 663-1130.

The enumeration date for this NPI number is 12/18/2019 and was last updated on 12/19/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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