Organization
GATEWAY PROFESSIONAL SERVICES, PC
Active
Parent organization
GATEWAY PROFESSIONAL SERVICES, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GATEWAY PROFESSIONAL SERVICES, PC
Authorized official
JEREMY K KLEMANSKI (CEO)
(312) 663-1130
Entity
Organization
Contact information
Practice address
404 N HERSHEY RD STE B, BLOOMINGTON, IL 61704-3560
(877) 381-6538
Mailing address
55 E JACKSON BLVD, CHICAGO, IL 60604-4466
(312) 663-1130
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
03/17/2023
Last updated
08/06/2024
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