Individual provider Active NPI

Jessica Lindsay Boland, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1093008443
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149015771 Issued in IL
Practice address
2001 S California Ave Ste 100
Chicago, IL 60608-2486
Phone
(773) 916-4437
Fax
(773) 376-8847
NPI assigned
May 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X 149015771 IL Primary

Addresses

Primary practice location

2001 S California Ave Ste 100
Chicago, IL 60608-2486

Mailing address

1910 N Drake Ave
Apt 1B
Chicago, IL 60647-7630
Phone (248) 342-5644

Other practice location 1

233 E Erie St Ste 207
Chicago, IL 60611-5938
Phone (312) 854-0061

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149015771ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nancy Eschbach LCSW and Associates Clinical CurrentSince Aug 24, 2021 Accepting new patients

Locations

636 S River Rd
Ste 100
Des Plaines, IL 60016
Phone (847) 877-3970

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1305676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1093008443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 N DRAKE AVE",
            "address_2": "APT 1B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606477630",
            "telephone_number": "248-342-5644",
            "fax_number": "248-342-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S CALIFORNIA AVE STE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606082486",
            "telephone_number": "773-916-4437",
            "fax_number": "773-376-8847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "233 E Erie St Ste 207",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606115938",
            "country_code": "US",
            "telephone_number": "312-854-0061",
            "fax_number": "312-650-8213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLAND",
        "first_name": "JESSICA",
        "middle_name": "LINDSAY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-18",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.