NPIMap

Organization Active NPI

Gateway Professional Services, PC

  • Addiction (Substance Use Disorder) Counselor
  • Chicago, IL
National Provider Identifier
1710528518
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
GATEWAY PROFESSIONAL SERVICES, PC
Practice address
55 E Jackson Blvd Ste 1500
Chicago, IL 60604-4184
Phone
(312) 663-1130
Fax
(312) 663-0504
NPI assigned
Oct 2, 2019
Last updated
Jun 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Authorized official

Name
Roueen Rafeyan, MD
Title
President
Phone
(312) 663-1130

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU
Addiction (Substance Use Disorder) Counselor 101YA0400X NU Primary

Addresses

Primary practice location

55 E Jackson Blvd Ste 1500
Chicago, IL 60604-4184

Mailing address

55 E Jackson Blvd Ste 1500
Chicago, IL 60604-4184
Phone (312) 663-1130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210512002910 IL Part B Supplier - Clinic/Group Practice 2961811401 Receives reassigned benefits from 5 practitioners
18 other NPIs on this enrollment
Practice locations: Swansea, IL; Springfield, IL; Skokie, IL; Peoria, IL; Lake Villa, IL; Joliet, IL; Jacksonville, IL; Downers Grove, IL…

Other NPIs on the same Medicare enrollment 18

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 18

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1569974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718323200000",
    "number": "1710528518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 E JACKSON BLVD STE 1500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606044184",
            "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": "55 E JACKSON BLVD STE 1500",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606044184",
            "telephone_number": "312-663-1130",
            "fax_number": "312-663-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY PROFESSIONAL SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-02",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A",
        "authorized_official_last_name": "RAFEYAN",
        "authorized_official_first_name": "ROUEEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-663-1130",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.