Paul Revis Md Sc

LBN: Paul Revis Md Sc
Paul Revis Md Sc is an health care organization with primary practice located at 1055 Featherstone , Rockford IL 61107. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Paul Revis Md Sc can be contacted via phone (815) 227-1055, or through Revis, Paul via phone (815) 227-1055.

Contact Information

Primary practice address
1055 Featherstone Rockford IL 61107
Phone: (815) 227-1055
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Revis, Paul Doctor of Medicine (MD)
Phone: (815) 227-1055

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 036067857 Illinois

Profile Details

NPI number 1952505422
LBN Legal business name Paul Revis Md Sc
DBA Doing business as
Authorized official Revis, Paul Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 11th, 2007
Last updated Jul 16th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952505422 NPPES
Illinois MEDICAID 036067857
Illinois Other 0010132251

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