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General NPI Number Information
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NPI Number | 1700327277
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Entity Type | Organization
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Legal Business Name | ROYALTY TRAVEL
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Dates
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Enumeration Date | 03/16/2017
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Last Update Date | 03/16/2017
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Provider Practice Location Address
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Address Line | 3647 W 80TH ST
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City | CHICAGO
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State | IL
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Zip | 60652-2413
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Country | US
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Telephone | 773-671-1635
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Fax |
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Provider Business Mailing Address
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Address Line | 3647 W 80TH ST
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City | CHICAGO
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State | IL
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Zip | 60652-2413
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Country | US
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Telephone | 773-671-1635
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | VERALEKA MITCHELL
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Credential |
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Telephone | 773-671-1635
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number | M32486080701
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License Number State | IL
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