Gateway Health Systems, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1010178 Issued in IL

Legal business name

GATEWAY HEALTH SYSTEMS, INC.

Practice address

222 Vollmer Rd
Chicago Heights, IL 60411-1664

Phone

(708) 754-9674

NPI assigned

Oct 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Ajibola A Ayeni, PHD, MD

Title

Administrator

Phone

(708) 754-9674

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396827317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2902 ALEXANDER CRES",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604221704",
            "telephone_number": "708-754-9674",
            "fax_number": "708-754-9796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 VOLLMER RD",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604111664",
            "telephone_number": "708-754-9674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY HEALTH SYSTEMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AYENI",
        "authorized_official_first_name": "AJIBOLA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "708-754-9674",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, MD"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1010178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE AGENCY LICENSE NUMB",
            "identifier": "1010178",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Chicago Heights, IL
• Providers in Chicago Heights, IL by specialty
• Home Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.