Organization
RESTORE CHANGE LLC
Active
Other names
Center for Hope, Action, Nourishment, Growth, and Empowerment
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FAHAD KHAN PSYD (EXECUTIVE DIRECTOR)
(630) 708-0120
Entity
Organization
Contact information
Practice address
1011 E WILSON AVE, LOMBARD, IL 60148-3765
(630) 708-0120
Mailing address
1011 E WILSON AVE, LOMBARD, IL 60148-3765
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
Primary
—
—
103TC0700X
Clinical Psychologist
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
12/01/2020
Last updated
12/01/2020
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