Individual
DR. RICHARD D TRAVIS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D, LCP
Contact information
Practice address
24123 W LOCKPORT ST, UNIT 101, PLAINFIELD, IL 60544-2863
(815) 436-1101
(815) 436-1121
Mailing address
24123 W LOCKPORT ST, UNIT 101, PLAINFIELD, IL 60544-2863
(815) 436-1101
(815) 436-1121
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
180003461
IL
103TC0700X
Clinical Psychologist
Primary
071.008003
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009932335
BCBS IL
IL
01
—
11723317
AETNA
IL
01
—
581473
VALUE OPTIONS
IL
01
—
802121000
MAGELLAN
IL
Enumeration date
10/23/2006
Last updated
01/17/2011
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