WAY BACK INN (NPI# 1093060741) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093060741 |
| Entity Type | Organization |
| Organization Name | WAY BACK INN |
| Practice Address |
1915 W Roosevelt Rd Broadview IL 60155-2925 |
| Practice Telephone | 7083443301 |
| Practice Fax Number | 7083442944 |
| Mailing Telephone | 7083443301 |
| Mailing Fax Number | 7083442944 |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2012-07-18 |
| Authorized Official Name | MS. ANITA MARIA PINDIUR (INTERIM EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7083443301 |
| Authorized Official Credential | M.S. L.C.P.C |
| Is Organization Subpart | Y |
| Parent Organization Name | WAY BACK INN |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
180.007316 | IL | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
180.007242 | IL | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
180.007316 | IL | Behavioral Health & Social Service Providers |
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
180.007242 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730472275 | Way Back Inn | Substance Abuse Rehabilitation Facility | 1915 W Roosevelt Rd, Broadview, IL 60155-2925 | 2011-05-17 |
| 1962880211 | Way Back Inn | Substance Abuse Rehabilitation Facility | 104 Oak St, Maywood, IL 60153-1676 | 2015-05-07 |
| 1467839803 | Way Back Inn | Substance Abuse Rehabilitation Facility | 104 Oak St, Maywood, IL 60153-1676 | 2015-05-06 |
| 1902283344 | Way Back Inn | Substance Abuse Rehabilitation Facility | 201 S 2nd Ave, Maywood, IL 60153-2303 | 2015-05-06 |
| Street Address |
1915 W ROOSEVELT RD |
| City | BROADVIEW |
| State | IL |
| Zip Code | 60155-2925 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730472275 | Way Back Inn | Substance Abuse Rehabilitation Facility | 1915 W Roosevelt Rd, Broadview, IL 60155-2925 | 2011-05-17 |
| 1124475405 | Katherine Goelitz | Counselor | 1915 W Roosevelt Rd, Broadview, IL 60155-2925 | 2016-05-17 |
| 1831580588 | Healthcare Alternative Systems, Inc. | Clinic/Center | 1915 W Roosevelt Rd, Broadview, IL 60155-2925 | 2015-02-16 |
| 1154669059 | Philip William Schneeberger | Counselor | 1915 W Roosevelt Rd, Broadview, IL 60155-2925 | 2013-01-28 |
| 1629316534 | Robert Francis Oconnor | Counselor | 1915 W Roosevelt Rd, Broadview, IL 60155-2925 | 2013-01-28 |
| 1538407572 | Mark G Vail | Counselor | 1915 W Roosevelt Rd, Broadview, IL 60155-2925 | 2013-01-25 |
| 1609114644 | Jill Elizabeth Tregler | Counselor | 1915 W Roosevelt Rd, Broadview, IL 60155-2925 | 2013-01-25 |
| 1710239678 | Anita Maria Pindiur | Counselor | 1915 W Roosevelt Rd, Broadview, IL 60155-2925 | 2012-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790176121 | Healthcare Alternative Systems, Inc. | Clinic/Center | 1915-17 W. Roosevelt Rd., Broadview, IL 60155 | 2015-02-06 |
| 1821379736 | Living Healthy Inc | Registered Nurse | 2205 W Roosevelt Road, Broadview, IL 60155 | 2011-09-06 |
| 1023324530 | Erin Reynolds | Nurse Practitioner | 800 Broadview Village Square, Broadview, IL 60155 | 2010-08-20 |
| 1285862490 | Patricia M Moser Od PC | Optometrist | 122-24 Broadview Village Square, Broadview, IL 60155 | 2009-06-25 |
| 1295762417 | Kiran Ram Bais | Family Medicine | 2127 S 17th Ave, Broadview, IL 60155 | 2006-06-26 |
| 1982092698 | Tiffany R Budzinski | Nurse Practitioner | 800 Broadview Village Square, Broadview, IL 60155 | 2015-01-05 |
| 1760789853 | Athletic and Therapeutic Institute of Naperville, LLC | Physical Therapist | 7000 Broadview Village Sq, Broadview, IL 60155-2600 | 2011-02-25 |
| 1083121263 | Lisa A Ufkes | Physical Therapist | 7000 Broadview Village Sq, Broadview, IL 60155-2600 | 2018-01-09 |
| 1093720203 | Walgreen Co | Pharmacy | 8000 Broadview Village Sq, Broadview, IL 60155-2601 | 2006-07-29 |
| 1467739904 | Brian Kubeczko | Pharmacist | 8000 Broadview Village Sq, Broadview, IL 60155-2601 | 2011-11-11 |
| Find all providers in zip 60155 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699864017 | Betty J Thomas | Counselor | 2332 S 22nd Ave, Broadview, IL 60155-3805 | 2006-10-12 |
| 1154669059 | Philip William Schneeberger | Counselor | 1915 W Roosevelt Rd, Broadview, IL 60155-2925 | 2013-01-28 |
| 1629316534 | Robert Francis Oconnor | Counselor | 1915 W Roosevelt Rd, Broadview, IL 60155-2925 | 2013-01-28 |
| 1538407572 | Mark G Vail | Counselor | 1915 W Roosevelt Rd, Broadview, IL 60155-2925 | 2013-01-25 |
| 1710239678 | Anita Maria Pindiur | Counselor | 1915 W Roosevelt Rd, Broadview, IL 60155-2925 | 2012-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669071932 | Euginia Ivanova | Counselor | 3410 W. Roosevelt Rd, Chicago, IL 60624 | 2020-10-19 |
| 1093322638 | New Horizon Mental and Behavioral Services | Counselor | 12052 S Lockwood Ave, Alsip, IL 60803-3165 | 2020-09-28 |
| 1780299818 | Sophia Bilikovsky | Counselor | 3025 Monterey Ln, Wadsworth, IL 60083-8924 | 2020-09-15 |
| 1497360697 | Cassandra Lynn Wegner | Counselor | 2529 Ravinia Ln, Woodridge, IL 60517-2241 | 2020-09-14 |
| 1831703131 | Colleen Mertens | Counselor | 100 Tower Dr Ste 236, Burr Ridge, IL 60527-5787 | 2020-09-03 |
| 1073127775 | Deborah Lynn Dettman | Counselor | 1209 W Sherwin Ave Apt 809, Chicago, IL 60626-2257 | 2020-09-01 |
| 1417574203 | Kathy O Valentin | Counselor | 1640 Pleasant Ln, Glenview, IL 60025-1847 | 2020-06-29 |
| 1669098844 | James Earl Brooks I | Counselor | 523 Clark St, South Beloit, IL 61080-1317 | 2020-06-23 |
| 1780200014 | Anchorpoint Adolescent Consultant Group Inc. | Counselor | 1246 N Yale Ave, Arlington Heights, IL 60004-4564 | 2020-06-23 |
| 1891311502 | Ashlie Jones | Counselor | 3226 Hoffman St, Plano, IL 60545-1992 | 2020-06-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.