TRAVIS R SMITH (NPI# 1619176021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619176021 |
| Entity Type | Individual |
| Full Name | TRAVIS R SMITH |
| Credential | PA-C |
| Practice Address |
1611 W Harrison St Ste 400 Chicago IL 60612-3841 |
| Mailing Address |
1 Westbrook Corporate Ctr #240 Westchester IL 60154-5701 |
| Practice Telephone | 3122434244 |
| Practice Fax Number | 3129421517 |
| Mailing Telephone | 7082362673 |
| Mailing Fax Number | 7084925673 |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2009-11-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
085002991 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE PTAN LOCALITY 15 | 209118 | 01 |
| IL | MEDICARE PTAN LOCALITY 16 | 209119 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467931287 | Travis Dean Smith | Contractor | 443 Grover Ln, Jamestown, TN 38556-5568 | 2018-08-13 |
| 1821591314 | Travis Smith | Hearing Instrument Specialist | 1950 Deyerle Ave Ste A, Harrisonburg, VA 22801-5423 | 2018-03-12 |
| 1487104139 | Travis Smith | Specialist/Technologist | 313 S 11th St, Bismarck, ND 58504-5621 | 2016-10-06 |
| 1538599006 | Travis Mark Smith | Social Worker | 1800 W Big Beaver Rd Ste 150, Troy, MI 48084-3535 | 2013-11-20 |
| 1245864958 | Travis Dale Smith | Counselor | 2255 W Northern Ave, Phoenix, AZ 85021-4936 | 2020-03-03 |
| 1477184869 | Travis Charles Smith | Physical Therapy Assistant | 420 Jett Dr, Jackson, KY 41339-9621 | 2020-02-04 |
| 1497222533 | Travis L Smith | Case Manager/Care Coordinator | 220 S Main St, Kendallville, IN 46755-1718 | 2018-10-26 |
| 1629544481 | Travis Nathan Smith | Massage Therapist | 216 E Chatham St Ste 110, Cary, NC 27511-3495 | 2018-10-19 |
| 1174015408 | Travis John Smith | Student in an Organized Health Care Education/Training Program | 500 University Dr, Hershey, PA 17033-2360 | 2018-06-01 |
| 1336501675 | Travis Smith | Student in an Organized Health Care Education/Training Program | 47 New Scotland Ave, Dept. of Neurology, Albany, NY 12208-3412 | 2016-03-25 |
| Street Address |
1611 W HARRISON ST STE 400 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60612-3841 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235138546 | Thomas J Nielsen | Otolaryngology | 1611 W Harrison St, Suite 550, Chicago, IL 60612-4861 | 2005-07-19 |
| 1699376996 | Lauren Kennerly | Registered Nurse | 1611 W Harrison St, Chicago, IL 60612-4861 | 2020-11-03 |
| 1225677404 | Mary Kathleen Walsh | Orthopaedic Surgery | 1611 W Harrison St, Chicago, IL 60612-4861 | 2020-01-05 |
| 1407417900 | Megan Merritt | Specialist/Technologist | 1611 W Harrison St, Chicago, IL 60612-4861 | 2019-06-25 |
| 1881253292 | Ellen Rohan | Physician Assistant | 1611 W Harrison St, Chicago, IL 60612-4861 | 2019-06-10 |
| 1588136154 | Elle Steele | Physician Assistant | 1611 W Harrison St, Chicago, IL 60612-4861 | 2018-12-20 |
| 1720591704 | Tricia Jacobs | Speech-Language Pathologist | 1611 W Harrison St, Chicago, IL 60612-4861 | 2017-11-13 |
| 1811415227 | Emily Marie Krogel | Nurse Practitioner | 1611 W Harrison St, Chicago, IL 60612-4861 | 2017-09-06 |
| 1104376912 | Paige Maher | Physician Assistant | 1611 W Harrison St, Ste 300, Chicago, IL 60612-4861 | 2016-10-05 |
| 1902350929 | Leah Kathleen Sparker | Specialist/Technologist | 1611 W Harrison St, Orthopedic Building Suite 530, Chicago, IL 60612-4861 | 2016-08-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1568080174 | Nastaran Ordoyo Haghani Rad | Student in an Organized Health Care Education/Training Program | 1950 W. Polk Street, Room 6203, Chicago, IL 60612 | 2020-07-09 |
| 1669090403 | Marianne Gagnon-konamna | Student in an Organized Health Care Education/Training Program | 1950 West Polk Street, Chicago, IL 60612 | 2020-07-08 |
| 1922625672 | Tanya Montgomery Nee Brown | Pediatrics | 1950 West Polk Street, Neonatal and Perinatal Department, Chicago, IL 60612 | 2020-06-29 |
| 1124643028 | Ashley Swan | Dentist | 801 S. Paulina St, Uic College of Dentistry - Endodontics Clinic, Chicago, IL 60612 | 2020-06-16 |
| 1831711381 | Baillie Anne Bronner | Obstetrics & Gynecology | 1653 W Congress Pkwy Chicago, Il 60612, Chicago, IL 60612 | 2020-05-07 |
| 1154942449 | Keisha Davell Cole | Case Manager/Care Coordinator | 612 S Western Ave Unit 1, Chicago, IL 60612 | 2020-04-28 |
| 1275153777 | Isac Lim | Student in an Organized Health Care Education/Training Program | 1234 S. Wells, Chicago, IL 60612 | 2020-04-24 |
| 1578183414 | Zachary Belden | Student in an Organized Health Care Education/Training Program | Uic Psychiatry Residency 912 S. Wood St., Rm 130b Npi-s (mc 913), Chicago, IL 60612 | 2020-04-21 |
| 1548880560 | Christina Nunez | Student in an Organized Health Care Education/Training Program | 801 S. Paulina Street, M/c 850, Chicago, IL 60612 | 2020-04-20 |
| Find all providers in zip 60612 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710547625 | Nadia Khan | Physician Assistant | 4543 N Malden St Apt 1s, Chicago, IL 60640-5687 | 2019-06-13 |
| 1962065516 | Jorge Mantilla | Physician Assistant | 5540 N Kimball Ave Apt 3e, Chicago, IL 60625-4674 | 2019-04-18 |
| 1770041949 | Laura Ann Ryan | Physician Assistant | 840 S Wood St Ste 417, Chicago, IL 60612-4325 | 2019-03-06 |
| 1407331184 | David Reyes | Physician Assistant | 2800 N Sheridan Rd Ste 209, Chicago, IL 60657-6157 | 2018-09-28 |
| 1053899138 | Won Hee Oh | Physician Assistant | 5841 S. Maryland Ave., Mc5040, Chicago, IL 60637 | 2018-08-01 |
| 1811494917 | Nicole Fisch | Physician Assistant | 7447 W Talcott Ave Ste 512, Chicago, IL 60631-3716 | 2018-04-06 |
| 1477909448 | Temidayo Olugbenga Odugbesan | Physician Assistant | 7016 S Sangamon St, Apt 3s, Chicago, IL 60621-1759 | 2016-05-10 |
| 1689096257 | Natalie Elizabeth Warmuth | Physician Assistant | 830 West Diversey Pkwy., Suite 300, Chicago, IL 60614-8711 | 2014-01-15 |
| 1184062754 | Lindsay Christine Jones | Physician Assistant | 205 East Huron, Northwestern Memorial Hospital Galter 11-140, Chicago, IL 60611 | 2013-06-05 |
| 1366741449 | Monica L Fiehler | Physician Assistant | 3537 Paysphere Cir, Chicago, IL 60674-0001 | 2011-03-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.