Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
REVIVE SKIN INSTITUTE LLC
Active OrganizationREVIVE SKIN INSTITUTE LLC is a Procedural Dermatology organization located in CARBONDALE, Illinois. NPI 1104178144 is currently active in the NPPES registry. Verify at CMS.
Procedural Dermatology · CARBONDALE, IL
Registration Details
- NPI Number
- 1104178144
- Provider Type
- Organization
- NPI Issued
- Oct 14, 2012 (13.843591297751 yrs)
- Last Updated
- Oct 14, 2012
- Licenses
-
036094335 (IL)036094335 (IL)
Practice Information
- Address
-
1175 CEDAR CTCARBONDALECARBONDALE, IL, 629015333Browse IL providers · Browse ZIP 62901
- Phone
- 6195490300
- Primary Specialty
-
Procedural Dermatology
207NS0135X
- Additional Specialty
- Procedural Dermatology
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.