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General NPI Number Information
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NPI Number | 1437970431
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Entity Type | Individual
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Provider Name | JACQUELINE O'BOYLE LCSW, CADC
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Gender | Female
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Dates
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Enumeration Date | 10/22/2024
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 600 CENTRAL AVE STE 370
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-3201
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Country | US
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Telephone | 312-643-0268
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Fax |
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Provider Business Mailing Address
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Address Line | 2122 N HALSTED ST APT 3
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City | CHICAGO
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State | IL
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Zip | 60614-6780
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Country | US
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Telephone | 415-209-3199
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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