Provider Demographics
NPI:1609340983
Name:NWI BEHAVIORAL & ADDICTION MEDICINE LLC
Entity type:Organization
Organization Name:NWI BEHAVIORAL & ADDICTION MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZATO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-841-7141
Mailing Address - Street 1:7805 TAFT ST
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-5233
Mailing Address - Country:US
Mailing Address - Phone:219-841-7141
Mailing Address - Fax:773-570-9682
Practice Address - Street 1:7805 TAFT ST
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-5233
Practice Address - Country:US
Practice Address - Phone:219-841-7141
Practice Address - Fax:773-570-9682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-19
Last Update Date:2019-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty