Individual provider Active NPI

Chloe Marie Boensch, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1730872979
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.025385 Issued in IL
Practice address
2500 W Bradley PL Ste 100
Chicago, IL 60618-4716
Phone
(708) 275-4692
NPI assigned
Jun 1, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.025385 IL Primary

Addresses

Primary practice location

2500 W Bradley PL Ste 100
Chicago, IL 60618-4716

Mailing address

2645 N Sacramento Ave Unit 1
Chicago, IL 60647-1713
Phone (708) 275-4692

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149.025385ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Free to Be Therapy Clinical Current Accepting new patients

Locations

2500 W Bradley Pl
Ste 100
Chicago, IL 60618
Phone (224) 306-1879

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": "1685577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1730872979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 N SACRAMENTO AVE UNIT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471713",
            "telephone_number": "708-275-4692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W BRADLEY PL STE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606184716",
            "telephone_number": "708-275-4692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOENSCH",
        "first_name": "CHLOE",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-01",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.025385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.