MR. TRAVIS MONTGOMERY


Address: 4400 W 95th St Ste 308, Oak Lawn, IL 60453-2660
Phone: 7083464040

MR. TRAVIS MONTGOMERY (NPI# 1679054696) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1679054696
Entity Type Individual
Full Name MR. TRAVIS MONTGOMERY
Credential RNFA
Practice Address 4400 W 95th St Ste 308
Oak Lawn
IL 60453-2660
Mailing Address 9500 Bormet Dr Ste 204
Mokena
IL 60448-8399
Practice Telephone 7083464040
Practice Fax Number 7083463287
Mailing Telephone 7083464044
Mailing Fax Number 7083463287
Enumeration Date 2018-08-27
Last Update Date 2020-04-08
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 246ZC0007X Specialist/Technologist, Other
Specialization: Surgical Assistant
238000654 IL Technologists, Technicians & Other Technical Service Providers
N 163WR0006X Registered Nurse
Specialization: Registered Nurse First Assistant
041472495 IL Nursing Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
IL IL RN LICENSE 041472495 01
IL IL SA LICENSE 238000654 01

Other Providers TRAVIS MONTGOMERY

NPI Name Taxonomy Address Enumeration
1154323731 Travis J Montgomery Podiatrist 3731 Guion Road, Suite C, Indianapolis, IN 46222-7604 2005-08-12
1316210040 Travis H Montgomery Physician Assistant 222 Medical Cir, Morehead, KY 40351-1179 2012-02-10

Office Location

Street Address 4400 W 95TH ST STE 308
City OAK LAWN
State IL
Zip Code 60453-2660

Providers in the same location

NPI Name Taxonomy Address Enumeration
1437159142 Philip Joseph Alexander Thoracic Surgery (Cardiothoracic Vascular Surgery) 4400 W 95th St Ste 308, Oak Lawn, IL 60453-2660 2005-07-22
1457912834 Shannon Lyn Mcnamara Physician Assistant 4400 W 95th St Ste 308, Oak Lawn, IL 60453-2660 2019-06-26
1043777832 Catherine Gaissert Physician Assistant 4400 W 95th St Ste 308, Oak Lawn, IL 60453-2660 2019-02-27
1558826735 Jeffrey Peyton Webb Nurse Practitioner 4400 W 95th St Ste 308, Oak Lawn, IL 60453-2660 2019-02-01
1407327638 Dakota Walther Physician Assistant 4400 W 95th St Ste 308, Oak Lawn, IL 60453-2660 2018-12-16
1538644273 Katarzyna M Krzycka Physician Assistant 4400 W 95th St Ste 308, Oak Lawn, IL 60453-2660 2018-09-28
1518463330 Nicole Annes Physician Assistant 4400 W 95th St Ste 308, Oak Lawn, IL 60453-2660 2018-04-02
1548769466 Laura Bergquist Specialist/Technologist, Other 4400 W 95th St Ste 308, Oak Lawn, IL 60453-2660 2018-02-06
1891208617 Jenifer K Wong-yu Physician Assistant 4400 W 95th St Ste 308, Oak Lawn, IL 60453-2660 2017-11-15
1285153536 Courtney Mcneill Physician Assistant 4400 W 95th St Ste 308, Oak Lawn, IL 60453-2660 2017-09-18
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1659995231 Natalia Zero Student in an Organized Health Care Education/Training Program 4440 W 95th St, Rm 131 North, Oak Lawn, IL 60453 2020-05-30
1114554300 Sylvia Maria Chlebek Student in an Organized Health Care Education/Training Program Advocate Christ Medical Center 4440 W. 95th St., Rm 131 North, Oak Lawn, IL 60453 2020-03-26
1972066751 Amanda Mroczek Family Medicine 9555 52nd Avenue, Suite F, Oak Lawn, IL 60453 2019-04-09
1013479955 Leah Rae Prager Physician Assistant 4400 W. 95th St., Attn: Pediatric General Surgery, Oak Lawn, IL 60453 2019-04-01
1659833473 Chelsea Sumida Gipson Family Medicine 9555 South 52nd Avenue, Suite F, Oak Lawn, IL 60453 2019-04-01
1518427418 Robert Lindgren Family Medicine 9555 S. 52nd Ave., Suite F, Oak Lawn, IL 60453 2019-03-25
1154886695 Stephanie Anne Comer Social Worker 10102 South Cicero Avenue, Suite C, Oak Lawn, IL 60453 2019-02-08
1700360070 Brian L Lee Counselor 8938 S Ridgeland Avenue Suite 100, Oak Lawn, IL 60453 2018-09-21
1679085245 International Dental of Oak Lawn Clinic/Center 9539 S Cicero Ave, Oak Lawn, IL 60453 2017-11-03
1124538301 Kavitha Rajendran Physician Assistant 5851 W. 95th Street, Suite 300, Oak Lawn, IL 60453 2017-10-02
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Taxonomy Information

Taxonomy Code 246ZC0007X
Grouping Technologists, Technicians & Other Technical Service Providers
Classification Specialist/Technologist, Other
Specialization Surgical Assistant

Taxonomy Definition

A surgical assistant is a skilled practitioner who has undergone formalized education and training as a surgical assistant. The surgical assistant performs surgical functions that include, but are not limited to: retracting, manipulating, suturing, clamping, cauterizing, litigating, and tying tissue; suctioning, irrigating and sponging; positioning the patient; closure of body planes and skin; and participating in hemostasis and volume replacement. Surgical assistants are certified and registered or licensed by the state, or, in states without licensure, certified as surgical assistants by completing appropriate education and training.
Notes: Source: Association of Surgical Assistants, 2014. [7/1/2014: title modified, definition modified] http://www.surgicalassistant.org/index.php/surgical-assisting Additional Resources: National Surgical Assistant Association, www.nsaa.net.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1558605451 Jorge Ramon Llobet-arce Specialist/Technologist, Other 9941 Mayfield Ave, Oak Lawn, IL 60453-3769 2012-11-15
1548769466 Laura Bergquist Specialist/Technologist, Other 4400 W 95th St Ste 308, Oak Lawn, IL 60453-2660 2018-02-06
1487191813 Ahmad Firas Allahham Specialist/Technologist, Other 4440 W 95th St, Oak Lawn, IL 60453-2600 2017-01-24
1811264260 Michael Huley Specialist/Technologist, Other 4440 W 95th St, Oak Lawn, IL 60453-2600 2011-11-29

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1568072288 Jaime Viramontes Jr. Specialist/Technologist, Other 2725 Technology Dr, Lombard, IL 60148-5675 2020-08-06
1215545660 Ghirri Health Care Inc Specialist/Technologist, Other 9101 Falcon Ridge Dr, Bridgeview, IL 60455-2608 2020-07-21
1649896606 Eric Dupaya Specialist/Technologist, Other 6432 S Eberhart Ave, Chicago, IL 60637-3325 2020-06-24
1508482027 Juan Carlos Diaz Specialist/Technologist, Other 1433 W Flournoy St Apt 3f, Chicago, IL 60607-3213 2020-06-20
1528682275 Alan George Specialist/Technologist, Other 606 N Van Auken St, Elmhurst, IL 60126-1947 2020-05-28
1881215416 Brianne O'leary Specialist/Technologist, Other 2413 Sunrise Cir, Aurora, IL 60503-6757 2020-05-05
1669006433 Michael Howard Keller Specialist/Technologist, Other 414 Chapel St, Marengo, IL 60152-3016 2020-03-02
1205487543 Muneif Abusaleh Specialist/Technologist, Other 10536 Forest Ln, Chicago Ridge, IL 60415-1820 2019-09-27
1831752773 Bienvenido Camacho Specialist/Technologist, Other 7900 W Deerwood Dr, Palos Park, IL 60464-2155 2019-04-16
1992278196 Deangela Roberson Specialist/Technologist, Other 1212 N. Lasalle, Ste 100/ Surgery Center, Chicago, IL 60610 2019-01-10
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Competitor

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City OAK LAWN
Zip Code 60453

Improve Information

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Dataset Information

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.

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