Provider Demographics
NPI:1841697265
Name:RESTOR MEDICAL INC
Entity type:Organization
Organization Name:RESTOR MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SARGENT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-682-5090
Mailing Address - Street 1:416 E ROOSEVELT RD
Mailing Address - Street 2:STE 107
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-5589
Mailing Address - Country:US
Mailing Address - Phone:630-682-5090
Mailing Address - Fax:630-260-1230
Practice Address - Street 1:416 E ROOSEVELT RD
Practice Address - Street 2:STE 107
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-5589
Practice Address - Country:US
Practice Address - Phone:630-682-5090
Practice Address - Fax:630-260-1230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-01
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty