Kingdom Living Outreach Services, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

A-5777-0001-A Issued in IL

Legal business name

KINGDOM LIVING OUTREACH SERVICES, INC

Practice address

20303 Crawford Ave
Suite 100
Olympia Fields, IL 60461-1073

Phone

(708) 747-9399

Fax

(708) 747-1908

NPI assigned

Oct 6, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Doris Palmer

Title

Executive Director

Phone

(708) 747-9399

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shirley Ann Golladay, MHS, CADC

  • Addiction (Substance Use Disorder) Counselor
  • Olympia Fields, IL
  • NPI 1003110289
  NPD (past)
• Joseph S Thomas Jr.

  • Addiction (Substance Use Disorder) Counselor
  • Olympia Fields, IL
  • NPI 1578817516
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1254787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254787200000",
    "number": "1659606895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20303 CRAWFORD AVE STE 100",
            "address_2": "P.O.BOX 1213, MATTESON, IL 60443",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611173",
            "telephone_number": "708-747-9399",
            "fax_number": "708-747-1908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20303 CRAWFORD AVE",
            "address_2": "SUITE 100",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611073",
            "telephone_number": "708-747-9399",
            "fax_number": "708-747-1908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGDOM LIVING OUTREACH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-06",
        "last_updated": "2009-10-06",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "DORIS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "708-747-9399",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "A-5777-0001-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Mae Kilianek
• Maryellen Kilkenny, CRNA
• Caroline Kim, DO
• Christine Young Kim, D.O.
• Teresa King
• Malgorzata Kiwacz, O.D.
• Anjelica Kokinias, DO
• Komedicine, LLC
• Shreya Kondle
• Nicholas Daniel Konicek, DO

• Community/Behavioral Health Agency in Olympia Fields, IL
• Providers in Olympia Fields, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.