NPIMap

Organization Active NPI

Gateway Foundation, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Lake Villa, IL
National Provider Identifier
1285883710
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
A-0538-0021-A Issued in IL
Legal business name
GATEWAY FOUNDATION, INC.
Practice address
25480 W Cedar Crest LN
Lake Villa, IL 60046-9744
Phone
(877) 505-4673
Fax
(847) 356-3033
NPI assigned
Sep 9, 2008
Organization subpart
Yes
Parent organization
GATEWAY FOUNDATION, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Renee Ennis McGee
Title
Manager
Phone
(678) 445-4833

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X A-0538-0021-A IL
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X A-0538-0021-A IL Primary
Substance Abuse Rehabilitation Facility 324500000X C/A-0538-0021-A IL
Children's Substance Abuse Rehabilitation Facility 3245S0500X A-0538-0021-A IL

Addresses

Primary practice location

25480 W Cedar Crest LN
Lake Villa, IL 60046-9744

Mailing address

55 E Jackson Blvd
Suite 1500
Chicago, IL 60604-4466
Phone (312) 663-1130

National Provider Directory

National Provider Directory
Tax ID family
Gateway Foundation Inc - BHC48 organizations share this tax ID, including this one
Part of
Gateway Foundation Inc - BHC

Other organizations with this tax ID 44

Organizations that report the same tax identification number in the National Provider Directory.

View all 44

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639612800000",
    "number": "1285883710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 E JACKSON BLVD",
            "address_2": "SUITE 1500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606044466",
            "telephone_number": "312-663-1130",
            "fax_number": "312-663-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25480 W CEDAR CREST LN",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "600469744",
            "telephone_number": "877-505-4673",
            "fax_number": "847-356-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY FOUNDATION, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GATEWAY FOUNDATION, INC",
        "enumeration_date": "2008-09-09",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A",
        "authorized_official_last_name": "MCGEE",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "ENNIS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "678-445-4833"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IL",
            "license": "A-0538-0021-A",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "IL",
            "license": "A-0538-0021-A",
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "IL",
            "license": "C/A-0538-0021-A",
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "IL",
            "license": "A-0538-0021-A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Villa, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.