Provider Demographics
NPI:1033202643
Name:JENSEN, CHRISTINA B (DC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:B
Last Name:JENSEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 NORTH SIXTH STREET
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:IL
Mailing Address - Zip Code:61061-0494
Mailing Address - Country:US
Mailing Address - Phone:815-732-2686
Mailing Address - Fax:
Practice Address - Street 1:200 NORTH SIXTH STREET
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:IL
Practice Address - Zip Code:61061-0494
Practice Address - Country:US
Practice Address - Phone:815-732-2686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0380047790111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor