MEDICARE: ROYALTY INTERVENTION GROUP, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	261Q00000X	Clinic/Center
3	208D00000X	General Practice Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609316389
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYALTY INTERVENTION GROUP, INC

Provider Business Mailing Address
First Line	:	2215 W 95TH ST
Second Line	:	1 EAST
City	:	CHICAGO
State	:	IL
Zip	:	60643-1001
Country	:	US
Telephone Number	:	773-239-9600
Fax Number	:	773-239-9601

Provider Business Practice Location Address
First Line	:	2215 W 95TH ST
Second Line	:	1 EAST
City	:	CHICAGO
State	:	IL
Zip	:	60643-1001
Country	:	US
Telephone Number	:	773-779-8260
Fax Number	:	773-779-8261

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MS. ANGELA J RATCLIFFE
Credential	:
Telephone Number	:	773-779-8260

Provider Enumeration Date	:	03/01/2017
Last Update Date	:	02/17/2018

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