TRAVIS CLINTON O'REAR
NPI 1104430990
Student in an Organized Health Care Education/Training Program in North Chicago, IL

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since August 31, 2020PECOS Enrolled

3333 GREEN BAY RD, NORTH CHICAGO, IL 60064(817) 944-4594 Get Directions Write a Review

NPPES record last updated: August 31, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Travis Clinton O'rear NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRAVIS CLINTON O'REAR (NPI 1104430990) is an individual student in an organized health care education/training program in North Chicago, Illinois and active in the NPI registry since August 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104430990

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameTRAVIS CLINTON O'REAR

Location Address3333 GREEN BAY RDNorth Chicago, IL 60064-3037

Mailing Address3333 Green Bay RdNorth Chicago, IL 60064-3037 · (817) 944-4594

Phone(817) 944-4594

Sole ProprietorYes

Enumeration DateAugust 31, 2020

NPPES CertifiedAugust 31, 2020

✔ NPI 1104430990 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

3333 GREEN BAY RD, North Chicago, IL 60064

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Travis Clinton O'rear is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.