Healthcare Provider Details

I. General information

NPI: 1528975562
Provider Name (Legal Business Name): SEAMUS W BOYLE LSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 N NORTHWEST HWY STE B2
PARK RIDGE IL
60068-3272
US

IV. Provider business mailing address

422 N NORTHWEST HWY STE B2
PARK RIDGE IL
60068-3272
US

V. Phone/Fax

Practice location:
  • Phone: 773-900-1919
  • Fax: 773-904-1919
Mailing address:
  • Phone: 773-900-1919
  • Fax: 773-904-1919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.130534
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: