Individual
MS. JACQUELINE JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR L
Contact information
Practice address
500 W SUPERIOR ST, #2204, CHICAGO, IL 60654-8132
(773) 738-6365
Mailing address
500 W SUPERIOR ST, #2204, CHICAGO, IL 60654-8132
(773) 738-6365
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
56007801
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1617235
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/20/2007
Last updated
05/21/2013
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