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NPI Code Detail

MEDICARE: CHRISTOPHER JENSEN MPT

MEDICARE: CHRISTOPHER JENSEN MPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT 30311FL
2225100000XPhysical Therapist070022896IL

General Provider Information

NPI Number : 1538433107
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER JENSEN MPT
Provider Business Mailing Address
First Line : 625 ENTERPRISE DR
Second Line :
City : OAK BROOK
State : IL
Zip : 60523-8813
Country : US
Telephone Number : 630-575-6250
Fax Number : 630-575-7450
Provider Business Practice Location Address
First Line : 24 E CHICAGO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60611-2009
Country : US
Telephone Number : 312-951-9700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/29/2012
Last Update Date : 07/21/2022

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