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General NPI Number Information
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NPI Number | 1548573728
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Entity Type | Individual
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Provider Name | TRAVIS RICHARD SATTERLEE LCPC
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Gender | Male
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Dates
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Enumeration Date | 07/16/2010
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Last Update Date | 07/16/2010
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Provider Practice Location Address
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Address Line | 4300 W IRVING PARK RD
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City | CHICAGO
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State | IL
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Zip | 60641-2825
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Country | US
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Telephone | 773-736-1447
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Fax | 773-736-6870
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Provider Business Mailing Address
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Address Line | 310 LAKE ST APARTMENT 2 SOUTH
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City | OAK PARK
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State | IL
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Zip | 60302-2641
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Country | US
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Telephone | 773-736-1447
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Fax | 773-736-6970
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180007115
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License Number State | IL
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