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Revive Skin Institute Llc
Procedural Dermatology Physician in Carbondale, Illinois
NPI 1104178144

Revive Skin Institute Llc is a Procedural Dermatology Physician based in Carbondale, IL and is specialized in Procedural Dermatology. Revive Skin Institute Llc practices in Carbondale, IL. The NPI Number for Revive Skin Institute Llc is 1104178144 and holds a License No. 036094335 (Illinois).

The current practice location address for Revive Skin Institute Llc is 1175 Cedar Ct, Carbondale, IL and can be reached out via phone at 619-549-0300.

Location: 1175 Cedar Ct, Carbondale, IL, 62901-5333
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1104178144
Provider Name
Revive Skin Institute Llc
Credential
Provider Entity Type
Organization
Address
1175 Cedar Ct, Carbondale, IL, 62901-5333
Phone Number
619-549-0300
Fax Number
Provider Enumeration Date
10/14/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
036094335 05 IL
institution
Provider Business Practice Location Address Details
Address
1175 Cedar Ct
City
Carbondale
State
Illinois
Zip
62901-5333
Phone Number
619-549-0300
Fax Number
person
Provider Business Mailing Address Details
Address
1175 Cedar Ct
City
Carbondale
State
Illinois
Zip
62901-5333
Phone Number
619-549-0300
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Dermatology
Speciality
-
Taxonomy
207N00000X
License No.
036094335 (Illinois)
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Dermatology
Speciality
Procedural Dermatology
Taxonomy
207NS0135X
License No.
036094335 (Illinois)
Definition
Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).
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