REVIVE SKIN INSTITUTE LLC
REVIVE SKIN INSTITUTE LLC is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1104178144, based in Carbondale, IL. The organization lists 2 taxonomy classifications, with Procedural Dermatology Physician recorded as primary.
Getting there
The practice address on file is 1175 CEDAR CT CARBONDALE, Carbondale, IL 62901. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 036094335 | IL | Procedural Dermatology Physician primary |
| 036094335 | IL | Dermatology Physician |
This provider holds licence 036094335 issued in IL. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
This NPI does not appear in the PECOS Medicare enrolment file. Providers who do not bill Medicare — or who bill only through a group's enrolment — will not appear here. It is not a sign of any problem with the registration.
What Procedural Dermatology covers
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). NUCC Health Care Provider Taxonomy, code 207NS0135X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 207NS0135X | Procedural Dermatology Physician Procedural Dermatology | 036094335 | IL | primary |
| 207N00000X | Dermatology Physician | 036094335 | IL |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1104178144 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | Oct 14, 2012 |
| Last updated | Oct 14, 2012 |
| Status | Active |
| Practice address |
1175 CEDAR CT CARBONDALE Carbondale, IL 62901 (619) 549-0300 |
| Other identifiers |
036094335
(IL) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 1 | 0 | 4 | 1 | 7 | 8 | 1 | 4 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 1 | 0 | 4 | 2 | 7 | 7 | 1 | 8 |
Sum = 56 · next multiple of 10 = 60 · check digit = 4 · actual last digit = 4
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.