NPIMap

Organization Active NPI

Way Back Inn

  • Addiction (Substance Use Disorder) Counselor
  • Maywood, IL
National Provider Identifier
1093060741
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
180.007242 Issued in IL
Legal business name
WAY BACK INN
Practice address
104 Oak St.
Maywood, IL 60153
Phone
(708) 344-3301
Fax
(708) 344-2944
NPI assigned
Jul 18, 2012
Organization subpart
Yes
Parent organization
WAY BACK INNAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Anita Maria Pindiur, M.S. L.C.P.C
Title
Interim Executive Director
Phone
(708) 344-3301

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X 180.007242 IL Primary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X 180.007316 IL
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X 180.007242 IL
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X 180.007316 IL

Addresses

Primary practice location

104 Oak St.
Maywood, IL 60153

Mailing address

104 Oak St.
Maywood, IL 60153
Phone (708) 344-3301

National Provider Directory

National Provider Directory
Tax ID family
Way Back Inn5 organizations share this tax ID, including this one
Part of
Way Back Inn

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1915 W Roosevelt Rd
Broadview, IL 60155
Phone (708) 344-3301

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1093060741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 OAK ST.",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-344-3301",
            "fax_number": "708-344-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 OAK ST.",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-344-3301",
            "fax_number": "708-344-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAY BACK INN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAY BACK INN",
        "enumeration_date": "2012-07-18",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "PINDIUR",
        "authorized_official_first_name": "ANITA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "INTERIM EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "708-344-3301",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S. L.C.P.C"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "180.007242",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "180.007316",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.007242",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.007316",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.