Restore Medical LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

RESTORE MEDICAL LLC

Practice address

411 Maxine Dr
Morton, IL 61550-2495

Phone

(309) 291-0988

Fax

(309) 291-0989

NPI assigned

Jan 30, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Alexander J Cummings, M.D.

Title

Vice President

Phone

(309) 291-0988

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1422576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422576000000",
    "number": "1972993814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 MAXINE DR",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615502495",
            "telephone_number": "309-291-0988",
            "fax_number": "309-291-0989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 MAXINE DR",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615502495",
            "telephone_number": "309-291-0988",
            "fax_number": "309-291-0989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-30",
        "last_updated": "2015-01-30",
        "status": "A",
        "authorized_official_last_name": "CUMMINGS",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "309-291-0988",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Morton, IL
• Providers in Morton, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2015; 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.