Organization
KINGDOM LIVING HEALTHCARE SC
Active
Organization
KINGDOM LIVING HEALTHCARE SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY L BUCKLES MD (CEO)
(773) 445-0292
Entity
Organization
Contact information
Practice address
1701 W MONTEREY AVE, SUITE 1, CHICAGO, IL 60643-4257
(773) 445-0292
Mailing address
1701 W MONTEREY AVE, SUITE 1, CHICAGO, IL 60643-4257
(773) 445-0292
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
IL
207R00000X
Internal Medicine Physician
Primary
—
IL
207T00000X
Neurological Surgery Physician
—
IL
208000000X
Pediatrics Physician
—
IL
Other
Enumeration date
06/13/2006
Last updated
09/11/2025
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