Organization
GATEWAY PROFESSIONAL SERVICES, PC
Active
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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