Dr. Timothy Anthony Buckley
Family Doctor
1300 W. Devon Avenue
Chicago
, Illinois 60660
Dr. Timothy Anthony Buckley
Family Doctor
1300 W. Devon Avenue
Chicago
, Illinois 60660
(773) 296-7637
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About
Features
Specialties
- Family Doctor
Languages spoken
- English
Location
First Address
- Dr. Timothy Anthony Buckley
- 3048 North Wilton Ave 2nd Floor
- Chicago, IL
- Zip : 60657-6710
- Fax : (773) 296-7637
- Phone : (773) 296-7544
Second Address
- Dr. Timothy Anthony Buckley
- 1300 W. Devon Avenue
- Chicago, IL
- Zip : 60660
- Fax : (773) 751-7854
- Phone : (773) 274-7355
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207Q00000X | Family Doctor | 036132513 | IL |
National Provider Identifier
| NPI | 1003135377 |
|---|---|
| Provider Name | Dr. Timothy Anthony Buckley |
| First Address | Chicago, IL 60657-6710 |
| Second Address | Chicago, IL 60660 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/05/2010 |
| Last Update Date | 26/10/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036132513 | (05) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.