Healthcare Provider Details

I. General information

NPI: 1043759939
Provider Name (Legal Business Name): ROYALTY INTERVENTION GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2017
Last Update Date: 02/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10307 S PEORIA ST SUITE 100
CHICAGO IL
60643-3007
US

IV. Provider business mailing address

10307 S PEORIA ST SUITE 100
CHICAGO IL
60643-3007
US

V. Phone/Fax

Practice location:
  • Phone: 708-715-1575
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: ANGELA RATCLIFFE
Title or Position: CEO
Credential:
Phone: 708-715-1575