Paul Revis MD Sc

NPI #1952505422 in Rockford, Illinois

Provider Information

NPI Number: 1952505422
Entity Type: Organization
Organization Name: Paul Revis MD Sc
Primary Specialty: Dermatology
Enumeration Date: Jun 11, 2007
Last Updated: Jul 16, 2008

Practice Location

Address: 1055 FEATHERSTONE
City: Rockford
State: Illinois
ZIP Code: 61107
Phone: (815) 227-1055

Authorized Official

Name: PAUL REVIS, MD
Title: OWNER PHYSICIAN
Phone: (815) 227-1055

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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