Individual ProviderJennifer L GrossheiderBehavior AnalystBehavioral Health & Social Service ProvidersPractice Address1530 S State St, Suite 15 N, Chicago, IL 60605-2973(630) 673-1211PECOS EnrollmentBased on the most recent information from CMS, provider Jennifer L Grossheider 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 34 days ago.Profile DetailsProvider ID1740595164Provider TypeIndividualFull NameGrossheider, Jennifer LTitleMs.GenderFemaleSole ProprietorYesEnumeration Date8/10/2010Last Updated8/10/2010Contact InformationPractice LocationPractice Address1530 S State St, Suite 15 N, Chicago, IL 60605-2973Phone(630) 673-1211Fax(773) 326-0725Mailing LocationMailing Address1530 S State St, Suite 15 N, Chicago, IL 60605-2973Phone(630) 673-1211Fax(773) 326-0725Provider TaxonomiesCodeDescriptionLicenseCode103K00000XPrimaryDescriptionBehavior AnalystBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer