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Individual

KIMBERLY JENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
800 AUDUBON WAY, LINCOLNSHIRE, IL 60069-3811
(847) 876-2200
(847) 876-2065
Mailing address
800 AUDUBON WAY, LINCOLNSHIRE, IL 60069-3811
(847) 876-2200
(847) 876-2265

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-110714
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04-91078
EVERCARE
IL
01
1982624763-4932996
BLUE CROSS BLUE SHIELD
IL
Enumeration date
07/25/2006
Last updated
04/21/2010
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