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Organization

GATEWAY FOUNDATION, INC.

Active
Find providers by NPI
Organization

GATEWAY FOUNDATION, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LATINA RUSSELL (CREDENTIALING SPECIALIST)
(312) 663-1130
Entity
Organization

Contact information

Practice address
4812 N SHERIDAN RD, PEORIA, IL 61614-5969
(877) 381-6538
Mailing address
55 E JACKSON BLVD STE 1500, CHICAGO, IL 60604-4184
(312) 663-1130
(312) 663-0504

Taxonomy

Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary

Other

Enumeration date
04/30/2024
Last updated
04/30/2024
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