Healthcare Provider Details

I. General information

NPI: 1609675271
Provider Name (Legal Business Name): CLOUDGATE HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 03/07/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 S MAIN ST STE 200
NAPERVILLE IL
60540-5485
US

IV. Provider business mailing address

50 S MAIN ST STE 200
NAPERVILLE IL
60540-5485
US

V. Phone/Fax

Practice location:
  • Phone: 630-780-0262
  • Fax:
Mailing address:
  • Phone: 630-780-0262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: ZACHARY J STAMP
Title or Position: CEO/PRESIDENT
Credential: CADC
Phone: 630-780-0262