Individual
JENSEN JACOB VAYALIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
351 WILLOWOOD LN, WILLOWBROOK, IL 60527-3900
(630) 280-5905
Mailing address
351 WILLOWOOD LN, WILLOWBROOK, IL 60527-3900
(630) 280-5905
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
125.085286
IL
Other
Enumeration date
03/27/2025
Last updated
06/08/2025
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