| Gateway Professional Services, Pc | |
|
600 W Lincoln Ave Caseyville IL 62232-1329 | |
| (877) 381-6538 | |
| Not Available |
| Full Name | Gateway Professional Services, Pc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 600 W Lincoln Ave, Caseyville, Illinois |
| Authorized Official Name and Position | Roueen Rafeyan (PRESIDENT) |
| Authorized Official Contact | 3126631130 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| 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 600 W Lincoln Ave Caseyville IL 62232-1329 Ph: (877) 381-6538 |
| NPI Number | 1316585797 |
|---|---|
| Provider Enumeration Date | 12/16/2019 |
| Last Update Date | 06/14/2024 |
| Certification Date | 06/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316585797 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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Gateway Foundation, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 600 W Lincoln Ave, Caseyville, IL 62232 Phone: 877-505-4673 Fax: 618-345-4398 | |
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