Paul Revis MD Sc

Public-record details

Address

1055 Featherstone Rd Ste C, Rockford, IL 61107

Phone

(815) 227-1055

Listed under

Practices and organizations

NPI

1952505422

NPI status

Active in the NPPES registry

Provider type

Organization (practice, clinic or company)

Registered specialty (self-reported taxonomy)

Dermatology (207N00000X)

License number on NPI record

036067857 (IL)

Authorized official

Paul Revis, MD, Physician

NPI first issued

Jun 11, 2007

Years since NPI first issued

19 years (since 2007)

License state on NPI record

IL

NPI record last updated

Mar 16, 2026

Medicare group enrollment (CMS)

Enrolled: listed in CMS Doctors & Clinicians as Paul Revis MD Sc

Clinicians in the Medicare group (all specialties, CMS)

2

Dermatology clinicians in the group at this ZIP (CMS)

1

Group Medicare assignment (CMS)

Accepts the Medicare-approved amount as payment in full

NPI 1952505422 is active in the federal NPPES registry (CMS) with Dermatology as its self-reported primary taxonomy; license 036067857 (IL) is listed on the record. CMS Doctors & Clinicians lists a Medicare-enrolled group with this name at this ZIP. Source: NPPES NPI Registry (CMS) (record). Data as of 2026-10-16.

Public record, not an endorsement. This listing was compiled from public records as of 2026-10-16 and may be incomplete or out of date. Dermatologist Index does not vet, employ, recommend or guarantee dermatology practices; a badge reflects only what the public record showed on that date. Confirm current details with the official record before you decide. The information on Dermatologist Index is not medical advice and does not replace a doctor, nurse, discharge planner or other qualified professional. Do not use it to make decisions about diagnosis or treatment. If you have a medical emergency, call 911. Full disclaimer · Report an error

What these registry facts mean

The NPI (National Provider Identifier) is the federal ID every HIPAA-covered provider uses to bill insurance. This NPI belongs to an organization, so it may cover several clinicians at this location. The specialty is the taxonomy the provider chose when registering; NPPES does not check it. A license number here is what the provider entered — confirm it with the state board before you rely on it. A registered specialty is not board certification. To check board certification, use the American Board of Dermatology's verification tool (or the American Osteopathic Board of Dermatology for DOs), and confirm the medical license with the state board.

View NPI 1952505422 in the official registry ↗