NPIMap

Organization Active NPI

Gateway Professional Services, PC

  • Adult Mental Health Clinic/Center
  • Downers Grove, IL
National Provider Identifier
1831785997
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
GATEWAY PROFESSIONAL SERVICES, PC
Practice address
3040 Finley Rd Ste 220
Downers Grove, IL 60515-5714
Phone
(877) 381-6538
NPI assigned
Dec 14, 2020
Organization subpart
Yes
Parent organization
GATEWAY PROFESSIONAL SERVICES, PCAs reported in NPPES

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
Joseph Zieba
Title
Manager of Managed Care Contracting
Phone
(312) 663-1130

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

3040 Finley Rd Ste 220
Downers Grove, IL 60515-5714

Mailing address

55 E Jackson Blvd Ste 1500
Chicago, IL 60604-4184
Phone (312) 502-1816

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
This NPI is an additional NPI on the 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
Tax ID family
Gateway Professional Services PC17 organizations share this tax ID, including this one
Part of
Gateway Professional Services PC

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718323200000",
    "number": "1831785997",
    "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": "312-502-1816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 FINLEY RD STE 220",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155714",
            "telephone_number": "877-381-6538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY PROFESSIONAL SERVICES, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GATEWAY PROFESSIONAL SERVICES, PC",
        "enumeration_date": "2020-12-14",
        "last_updated": "2024-06-14",
        "certification_date": "2021-04-28",
        "status": "A",
        "authorized_official_last_name": "ZIEBA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "MANAGER OF MANAGED CARE CONTRACTING",
        "authorized_official_telephone_number": "312-663-1130"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, 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.