Individual ProviderTheresa PendergraffSocial WorkerBehavioral Health & Social Service ProvidersPractice Address4150 N Kilbourn Ave, Chicago, IL 60641-1913(312) 342-8155PECOS EnrollmentBased on the most recent information from CMS, provider Theresa Pendergraff is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1245747542Provider TypeIndividualFull NamePendergraff, TheresaGenderFemaleSole ProprietorNoEnumeration Date1/8/2018Last Updated12/27/2022Contact InformationPractice LocationPractice Address4150 N Kilbourn Ave, Chicago, IL 60641-1913Phone(312) 342-8155FaxUnlisted FaxMailing LocationMailing Address4150 N Kilbourn Ave, Chicago, IL 60641-1913Phone(312) 342-8155FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense149018482Illinois