Organization
REVELATIONS RX PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DORIS VAN BYSSUM (MEMBER/OWNER)
(630) 858-0875
Entity
Organization
Contact information
Practice address
640 N RIVER RD STE 108, NAPERVILLE, IL 60563-8947
(630) 858-0875
Mailing address
174 S MONTCLAIR AVE, GLEN ELLYN, IL 60137-6357
(630) 858-0875
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/23/2023
Last updated
11/07/2023
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