| Paul Revis, MD | |
|
1055 Featherstone Rd, Rockford, IL 61107-5904 | |
| (815) 227-1055 | |
| Not Available |
| Full Name | Paul Revis |
|---|---|
| Gender | Male |
| Speciality | Dermatology |
| Experience | 43 Years |
| Location | 1055 Featherstone Rd, Rockford, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518984293 | NPI | - | NPPES |
| 036067857 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | 036067857 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Swedish American Hospital | Rockford, IL | Hospital |
| Osf Saint Anthony Medical Center | Rockford, IL | Hospital |
| Entity Name | Paul Revis Md Sc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952505422 PECOS PAC ID: 0547360943 Enrollment ID: O20070714000077 |
| Mailing Address | Practice Location Address |
|---|---|
| Paul Revis, MD 1055 Featherstone Rd Ste C, Rockford, IL 61107-5904 Ph: () - | Paul Revis, MD 1055 Featherstone Rd, Rockford, IL 61107-5904 Ph: (815) 227-1055 |
Albert W. Hudson, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 698 Featherstone Rd, Rockford, IL 61107 Phone: 815-398-3277 | |
Amy L Brodsky, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 5995 Spring Creek Rd, Rockford, IL 61114 Phone: 815-977-4403 | |
Dr. Melissa L Stenstrom, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1235 N Mulford Rd, Suite 205, Rockford, IL 61107 Phone: 815-484-9900 Fax: 815-487-4949 | |
Dr. Lakimerly Michelle Coates, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 4338 Morsay Dr, Rockford, IL 61107 Phone: 815-399-6400 Fax: 815-399-4424 | |
Maria I Al-basha, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1639 N Alpine Rd, Rockford, IL 61107 Phone: 815-229-9333 |