Restore Change LLC

NPI #1356946008 in Lombard, Illinois

Provider Information

NPI Number: 1356946008
Entity Type: Organization
Organization Name: Restore Change LLC
Primary Specialty: Psychologist
Enumeration Date: Dec 1, 2020
Last Updated: Dec 1, 2020

Practice Location

Address: 1011 E WILSON AVE
City: Lombard
State: Illinois
ZIP Code: 60148-3765
Phone: (630) 708-0120

Authorized Official

Name: DR. FAHAD KHAN, PSYD
Title: EXECUTIVE DIRECTOR
Phone: (630) 708-0120

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Psychologist - Clinical — Clinical	103TC0700X
Psychiatry & Neurology - Psychiatry — Psychiatry	2084P0800X
Psychologist	103T00000X	Primary

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