| Gateway Professional Services, Pc | |
|
55 E Jackson Blvd Ste 1500 Chicago IL 60604-4184 | |
| (312) 663-1130 | |
| (312) 663-0504 |
| Full Name | Gateway Professional Services, Pc |
|---|---|
| Speciality | Counselor |
| Location | 55 E Jackson Blvd Ste 1500, Chicago, Illinois |
| Authorized Official Name and Position | Roueen Rafeyan (PRESIDENT) |
| Authorized Official Contact | 3126631130 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Professional Services, Pc 55 E Jackson Blvd Ste 1500 Chicago IL 60604-4184 Ph: (312) 663-1130 | Gateway Professional Services, Pc 55 E Jackson Blvd Ste 1500 Chicago IL 60604-4184 Ph: (312) 663-1130 |
| NPI Number | 1710528518 |
|---|---|
| Provider Enumeration Date | 10/02/2019 |
| Last Update Date | 06/14/2024 |
| Certification Date | 06/14/2024 |
| Medicare PECOS PAC ID | 2961811401 |
|---|---|
| Medicare Enrollment ID | O20210512002910 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710528518 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Ariana Sandoval |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275155764 PECOS PAC ID: 5496915431 Enrollment ID: I20200717002316 |
| Provider Name | Ricardo Orozco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518579168 PECOS PAC ID: 4981021086 Enrollment ID: I20200903002633 |
| Provider Name | Catherine Nevels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326558222 PECOS PAC ID: 8325307754 Enrollment ID: I20230519000334 |
| Provider Name | Shalu P. Gugnani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629238746 PECOS PAC ID: 6800018409 Enrollment ID: I20240611002955 |
Philip K Mccullough Md Sc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 E Huron St, Suite 11-100, Chicago, IL 60611 Phone: 312-695-3680 Fax: 312-926-3709 | |
Amy Lynn, Lcpc, Atr Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3020 N Lincoln Ave, Flourish Studios, Chicago, IL 60657 Phone: 773-746-7429 | |
K.a.m Alliance, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2215 W 95th St Ste 100, Chicago, IL 60643 Phone: 773-239-9600 Fax: 773-239-9601 | |
King Community Mental Health Center Corp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4455 S King Drive, Suite 101, Chicago, IL 60653 Phone: 773-536-2700 Fax: 773-751-2250 | |
Young Adult Program Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4219 N Lincoln Ave, Chicago, IL 60618 Phone: 773-572-5500 Fax: 773-537-3488 | |
Professional Diagnostic Service, S.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 821 W Van Buren St, Chicago, IL 60607 Phone: 312-491-0404 Fax: 312-491-0505 | |
Universal Medical Group Ltd. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 809 E 42nd Pl, Chicago, IL 60653 Phone: 773-285-3422 |