Individual
LOGAN TRAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-5375
(708) 684-1028
Mailing address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-5375
(708) 684-1028
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01079994A
IN
390200000X
Student in an Organized Health Care Education/Training Program
125.067136
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0345541
—
OH
Enumeration date
06/25/2015
Last updated
10/06/2025
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