Organization
RESTORE PHYSICAL THERAPY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERICK M RUSSELL PT (PRESIDENT)
(708) 660-9355
Entity
Organization
Contact information
Practice address
6326 ROOSEVELT RD, OAK PARK, IL 60304-2313
(708) 660-9355
(708) 660-9356
Mailing address
6326 ROOSEVELT RD, OAK PARK, IL 60304-2313
(708) 660-9355
(708) 660-9356
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
070013337
IL
Other
Enumeration date
01/26/2009
Last updated
03/02/2009
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