Provider Demographics
NPI:1699151829
Name:GATEWAY TO LEARNING
Entity type:Organization
Organization Name:GATEWAY TO LEARNING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HENNELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-784-3200
Mailing Address - Street 1:4925 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-2609
Mailing Address - Country:US
Mailing Address - Phone:773-784-3200
Mailing Address - Fax:773-784-3299
Practice Address - Street 1:4925 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-2609
Practice Address - Country:US
Practice Address - Phone:773-784-3200
Practice Address - Fax:773-784-3299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL20150720817620Medicaid