NPIMap

Organization Active NPI

Restorative Life Services, LLC

  • Clinical Social Worker
  • Flossmoor, IL
National Provider Identifier
1285981506
Registry record updated Aug 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
RESTORATIVE LIFE SERVICES, LLC
Practice address
169624 Governors Highway
Flossmoor, IL 60422
Phone
(773) 412-5260
NPI assigned
Aug 6, 2012
Last updated
Aug 6, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ghana Cooper, LCSW, D.MINNPI 1790030922
Title
Owner
Phone
(773) 726-9775

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

169624 Governors Highway
Flossmoor, IL 60422

Mailing address

4553 S Michigan Ave
Chicago, IL 60653-3997
Phone (773) 726-9775

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1344211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344211200000",
    "number": "1285981506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4553 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606533997",
            "telephone_number": "773-726-9775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169624 GOVERNORS HIGHWAY",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "60422",
            "telephone_number": "773-412-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATIVE LIFE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-06",
        "last_updated": "2012-08-06",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "GHANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-726-9775",
        "authorized_official_credential": "LCSW, D.MIN"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flossmoor, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.