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Individual

MR. DONALD MILTON JENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1725 W. HARRISON STREET, SUITE 158, CHICAGO, IL 60612
(312) 942-8910
Mailing address
1725 W. HARRISON STREET, SUITE 158, CHICAGO, IL 60612
(312) 942-8910

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.048965
IL
207RG0100X
Gastroenterology Physician
036.048965
IL
207RG0100X
Gastroenterology Physician
036048965
IL
207RI0008X
Hepatology Physician
Primary
036.048965
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036048965
IL
Enumeration date
12/13/2006
Last updated
03/22/2016
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