Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Boom Wellness PLLC

Organization Clinical Social Worker · NPI 1326800988

Boom Wellness PLLC is a Clinical Social Worker in Chicago, Illinois. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4328 S Fairfield Ave
Chicago, IL 60632-1223
Phone: (219) 617-9162
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1326800988
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jamika Walton — Owner · (312) 574-0025
NPI enumeratedJanuary 29, 2024
Last updated in NPPESJanuary 29, 2024
Certification dateJanuary 29, 2024
Mailing address4328 S Fairfield Ave, Chicago, IL 60632-1223

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