MR. TRAVIS MONTGOMERY RNFA
NPI 1679054696
Specialist/Technologist, Other - Surgical Assistant in Oak Lawn, IL

Q: What is Travis Montgomery's NPI number?

The NPI number for Travis Montgomery is 1679054696. It was assigned to this individual provider in the NPPES registry on August 27, 2018.

Q: What is Travis Montgomery's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, Other, specializing in Surgical Assistant, with taxonomy code 246ZC0007X.

Q: When was this NPI record last updated?

The NPPES record for Travis Montgomery was last updated on April 8, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 27, 2018

4400 W 95TH ST STE 308, OAK LAWN, IL 60453(708) 346-4040(708) 346-3287 Get Directions Write a Review

NPPES record last updated: April 8, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 8, 2020, Aug 27, 2018 (2 updates tracked since 2018).

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About Mr. Travis Montgomery Rnfa NPPES

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

MR. TRAVIS MONTGOMERY RNFA (NPI 1679054696) is an individual surgical assistant in Oak Lawn, Illinois, licensed in Illinois (238000654) and active in the NPI registry since August 2018.

NPPES Registry Identity

NPI1679054696

Entity TypeIndividualMale

Primary Taxonomy246ZC0007X

Provider Legal NameMR. TRAVIS MONTGOMERYCredential: RNFA

Location Address4400 W 95TH ST STE 308Oak Lawn, IL 60453-2660

Mailing Address9500 Bormet Dr Ste 204Mokena, IL 60448-8399 · (708) 346-4044 · Fax (708) 346-3287

Phone(708) 346-4040

Fax(708) 346-3287

Sole ProprietorYes

Enumeration DateAugust 27, 2018

Last NPPES UpdateApril 8, 20202 updates tracked since enumeration

NPPES CertifiedApril 8, 2020

✔ NPI 1679054696 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySpecialist/Technologist, Other · Surgical AssistantTechnologists, Technicians & Other Technical Service Providers

Taxonomy Code246ZC0007X

License✔ Licensed in IL · 238000654

Definition

A surgical assistant is a skilled practitioner who has undergone formalized education and training as a surgical assistant. The surgical assistant performs surgical functions that include, but are not limited to: retracting, manipulating, suturing, clamping, cauterizing, litigating, and tying tissue; suctioning, irrigating and sponging; positioning the patient; closure of body planes and skin; and participating in hemostasis and volume replacement. Surgical assistants are certified and registered or licensed by the state, or, in states without licensure, certified as surgical assistants by completing appropriate education and training.

Also ListedRegistered Nurse · Registered Nurse First AssistantTaxonomy 163WR0006X · License 041472495 (IL)

4400 W 95TH ST STE 308, Oak Lawn, IL 60453

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Other Identifiers 2

Other041472495IL · Il Rn License

Other238000654IL · Il Sa License

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAURA BERGQUIST CST/CSFA

Specialist/Technologist, Other (Surgical Assistant)