Paul Revis MD SC
NPI 1952505422ActiveOrganization· Dermatology· Rockford, IL
Dermatology in Rockford, Illinois, registered in NPPES in June 2007. The authorized official on file is Paul Revis, MD, Physician. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1952505422 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 11, 2007 |
| Last updated in NPPES | Mar 16, 2026 |
| Certified by provider | Mar 16, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | 036067857 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IL) |
|---|
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