Provider Demographics
NPI:1093070922
Name:ROY, MICHEL Y (DC, DO,ND,HM)
Entity Type:Individual
Prefix:DR
First Name:MICHEL
Middle Name:Y
Last Name:ROY
Suffix:
Gender:M
Credentials:DC, DO,ND,HM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 N PEORIA ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-2609
Mailing Address - Country:US
Mailing Address - Phone:312-346-9355
Mailing Address - Fax:
Practice Address - Street 1:16 N PEORIA ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-2609
Practice Address - Country:US
Practice Address - Phone:312-346-9355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-06
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011609111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor