NPIMap

Organization Active NPI

Gateway Foundation Inc.

  • Substance Abuse Rehabilitation Facility
  • Lake Villa, IL
National Provider Identifier
1417312661
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
GATEWAY FOUNDATION INC.
Practice address
25480 W Cedar Crest LN
Lake Villa, IL 60046-9744
Phone
(847) 356-8205
Fax
(847) 356-3033
NPI assigned
Dec 15, 2015
Last updated
Dec 22, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
GATEWAY FOUNDATION, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Authorized official

Name
Latina Russell
Title
Contract and Cred Specialist
Phone
(312) 663-1130

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

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) 666-1130

National Provider Directory

National Provider Directory
Tax ID family
Gateway Foundation Inc - BHC45 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": "1450137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640131200000",
    "number": "1417312661",
    "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": "312-666-1130",
            "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": "847-356-8205",
            "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": "2015-12-15",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "LATINA",
        "authorized_official_title_or_position": "CONTRACT AND CRED SPECIALIST",
        "authorized_official_telephone_number": "312-663-1130"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 22, 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.