MEDICARE: JENNIFER GRAUS LCPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	180013335	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518413277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER GRAUS LCPC

Provider Business Mailing Address
First Line	:	6177 N LINCOLN AVE # 301
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-2313
Country	:	US
Telephone Number	:	847-780-7086
Fax Number	:

Provider Business Practice Location Address
First Line	:	1828 W WEBSTER AVE STE 450
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-2916
Country	:	US
Telephone Number	:	847-780-7086
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2016
Last Update Date	:	11/19/2022

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