Organization
RESTORE NEUROREHAB PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK ANDREW FASICK PT, MS, NCS (MANAGER)
(847) 345-3375
Entity
Organization
Contact information
Practice address
1529 S GROVE AVE, BARRINGTON, IL 60010-5211
(847) 800-6162
Mailing address
306 S WAVERLY PL, MT PROSPECT, IL 60056-2939
(847) 345-3375
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Enumeration date
11/20/2021
Last updated
11/20/2021
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