Individual
MOLLY MARGARET REVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
15728 S ROUTE 59, PLAINFIELD, IL 60544-2693
(815) 436-8831
Mailing address
15728 S ROUTE 59, PLAINFIELD, IL 60544-2693
(815) 436-8831
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085010053
IL
Other
Enumeration date
09/13/2023
Last updated
11/08/2023
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