NPIMap

Organization Active NPI

Way Back Inn

  • Substance Abuse Rehabilitation Facility
  • Oak Park, IL
National Provider Identifier
1962880211
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
A-0388-0004-A Issued in IL
Legal business name
WAY BACK INN
Practice address
412 S. Wesley
Oak Park, IL 60302
Phone
(708) 344-3301
Fax
(708) 344-2944
NPI assigned
May 7, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Authorized official

Name
Anita Pindiur, MS, LCPC, CADC
Title
Executive Director
Phone
(708) 344-3301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X A-0388-0004-A IL Primary

Addresses

Primary practice location

412 S. Wesley
Oak Park, IL 60302

Mailing address

104 Oak Street
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

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1430956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655164800000",
    "number": "1962880211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 OAK STREET",
            "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": "412 S. WESLEY",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "60302",
            "telephone_number": "708-344-3301",
            "fax_number": "708-344-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAY BACK INN",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-07",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A",
        "authorized_official_last_name": "PINDIUR",
        "authorized_official_first_name": "ANITA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "708-344-3301",
        "authorized_official_credential": "MS, LCPC, CADC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "IL",
            "license": "A-0388-0004-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.