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Individual

KENNETH DALE RESTOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
APRN

Contact information

Practice address
15 SPINNING WHEEL RD STE 30, HINSDALE, IL 60521-7651
(630) 259-1515
Mailing address
8053 KOLMAR AVE, SKOKIE, IL 60076-3114
(847) 558-9852

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209020225
IL

Other

Enumeration date
01/13/2020
Last updated
01/13/2020
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