Individual
TRAVIS R SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4847 HOFFMAN BLVD, HOFFMAN ESTATES, IL 60192-3722
(847) 685-4646
(847) 685-4631
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
(847) 390-4757
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085002991
IL
363AS0400X
Surgical Physician Assistant
085002991
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209118
MEDICARE PTAN LOCALITY 15
IL
01
—
209119
MEDICARE PTAN LOCALITY 16
IL
Enumeration date
07/16/2007
Last updated
03/05/2026
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