Provider Demographics
NPI:1518912039
Name:RESTORATIVE SOLUTIONS INC
Entity Type:Organization
Organization Name:RESTORATIVE SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:CHAMBERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-365-5244
Mailing Address - Street 1:4N323 DERBY LANE
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-7925
Mailing Address - Country:US
Mailing Address - Phone:630-416-1035
Mailing Address - Fax:630-416-1038
Practice Address - Street 1:4N323 DERBY LANE
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175-7925
Practice Address - Country:US
Practice Address - Phone:630-416-1035
Practice Address - Fax:630-416-1038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
1518912039OtherBLUECROSS OF ILLINOIS
4268430001Medicare NSC