Individual ProviderJennifer MartinezSocial WorkerBehavioral Health & Social Service ProvidersPractice Address639 W Diversey Pkwy, Chicago, IL 60614-1501(773) 312-5265PECOS EnrollmentBased on the most recent information from CMS, provider Jennifer Martinez does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1497018170Provider TypeIndividualFull NameMartinez, JenniferCredentialLCSWGenderFemaleSole ProprietorNoEnumeration Date6/19/2012Last Updated9/27/2022Contact InformationPractice LocationPractice Address639 W Diversey Pkwy, Chicago, IL 60614-1501Phone(773) 312-5265FaxUnlisted FaxMailing LocationMailing Address639 W Diversey Pkwy Ste 408, Chicago, IL 60614-1501Phone(773) 312-5265FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense149.014238Illinois