Revive Skin Institute LLC
Revive Skin Institute LLC provides Dermatology Physician services in Carbondale, Illinois. Licensed in Illinois. Registered with an NPI since 2012.
- Licensed in
- IL
- In the registry since
- 2012
- Specialties on file
- 2
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
1175 Cedar CT CarbondaleCarbondale, IL 62901-5333 Not confirmed with CMS for 13 years — call before visiting
Phone: (619) 549-0300
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Procedural Dermatology Physician (primary) | Taxonomy 207NS0135X · Licence 036094335 (IL) |
|---|---|
| Dermatology Physician | Taxonomy 207N00000X · Licence 036094335 (IL) |
Record details
| NPI number | 1104178144 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Anup Chaudhry — Member · (618) 549-0300 |
| Other names | Dermatology |
| NPI enumerated | October 14, 2012 |
| Last updated in NPPES | October 14, 2012 |
| Mailing address | 1175 Cedar Ct, Carbondale, Carbondale, IL 62901-5333 |
Other providers in Carbondale
-
Dr. Anup K Chaudhry, MD
1175 Cedar Ct, Carbondale, IL 62901-5333 · (618) 549-0300
-
Dr. Hal Aaron Lewis, MD
1400 Financial Park, Carbondale, IL 62902-7537 · (618) 351-9140
-
Mark L Westphal
665 E Lake Rd, Carbondale, IL 62901-5347 · (618) 549-0841
-
Dr. Susan Schaberg, MD
2601 W Main St, Carbondale, IL 62901-1031 · (618) 549-5361
-
Mark Louis Westphal, MD
665 E Lake Rd, Carbondale, IL 62901-5347 · (618) 549-0841