Laquay Boone

Individual provider Active NPI Clinical Social Worker · Blue Island, IL

NPI 1023940657 · NPPES record last updated May 29, 2026

Key facts

NPI
1023940657
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
149.031868 (IL)
Practice address
2856 140TH St
Blue Island, IL 60406-3346
Phone
(708) 925-6601
NPI assigned
May 29, 2026
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
149.031868ILMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.031868 IL Yes

Addresses

Primary practice location

2856 140TH St
Blue Island, IL 60406-3346

Mailing address

2856 140TH St
Blue Island, IL 60406-3346

Other providers in Blue Island, IL

All providers in Blue Island, IL · Clinical Social Worker in Illinois

Sources for this page

Verify at the official NPI Registry.