Individual provider Active NPI

Jessica Hewetson Gruber, BCBA-D, PHD, LBA

  • Behavior Analyst
  • Chicago, IL
National Provider Identifier
1811303282
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
152000103 Issued in IL
Practice address
2701 W Peterson Ave
Chicago, IL 60659-3919
Phone
(224) 258-2570
Fax
(224) 241-3132
NPI assigned
Jul 7, 2014
Last updated
Mar 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 152000103 IL Primary

Addresses

Primary practice location

2701 W Peterson Ave
Chicago, IL 60659-3919

Mailing address

8609 W Bryn Mawr Ave Ste 204
Chicago, IL 60631-3524
Phone (708) 306-2744

Other practice location 1

212 S Marion St
Oak Park, IL 60302-3159
Phone (708) 358-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
152000103ILMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Autism Evaluation Center at the Place Past Accepting new patients
Djje Holdings LLC Behavior Analyst Past Accepting new patients
The Place for Speech Therapy LLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1811303282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8609 W BRYN MAWR AVE STE 204",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313524",
            "telephone_number": "708-306-2744",
            "fax_number": "224-241-3132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593919",
            "telephone_number": "224-258-2570",
            "fax_number": "224-241-3132"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 S Marion St",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603023159",
            "country_code": "US",
            "telephone_number": "708-358-3000",
            "fax_number": "708-524-0300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRUBER",
        "first_name": "JESSICA",
        "middle_name": "HEWETSON",
        "name_prefix": "Dr.",
        "credential": "BCBA-D, PHD, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-07",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "152000103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.