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NPI Code Detail

MEDICARE: CHICO JENSEN

MEDICARE: CHICO JENSEN
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1972452746
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHICO JENSEN
Provider Business Mailing Address
First Line : 2885 W BATTLEFIELD ST
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65807-3952
Country : US
Telephone Number : 317-882-5122
Fax Number :
Provider Business Practice Location Address
First Line : 8320 MADISON AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46227-6066
Country : US
Telephone Number : 317-882-5122
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2026
Last Update Date : 01/26/2026

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Directions to “ CHICO JENSEN ” Practice Location

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