Individual
DR. ADAM RANDOLPH TRAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
565 W QUINCY ST UNIT 1613, CHICAGO, IL 60661-2912
(502) 338-3580
Mailing address
565 W QUINCY ST UNIT 1613, CHICAGO, IL 60661-2912
(502) 338-3580
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036127714
IL
Other
Enumeration date
06/19/2008
Last updated
05/06/2013
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