Emily Elise Jensen, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

085004165 Issued in IL

Practice address

391 S Bolingbrook Dr
Bolingbrook, IL 60440-3411

Phone

(630) 226-1006

NPI assigned

Oct 13, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Edward Health Ventures

  • Multi-Specialty Clinic/Center
  • Bolingbrook, IL
  • NPI 1962452912
  Medicare reassignment NPD
• Endeavor Health Medical Group

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882
  Medicare reassignment
• Physicians Immediate Care North Chicago LLC

  • Urgent Care Clinic/Center
  • Chicago, IL
  • NPI 1205814118
  Medicare reassignment
• Rogers Medical, LTD

  • Family Medicine Physician
  • Plainfield, IL
  • NPI 1992992820
  Medicare reassignment
• Endeavor Health Medical Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD
• Fastrac Medical, P.C.

  • Emergency Medicine Physician
  • Joliet, IL
  • NPI 1659517597
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388102400000",
    "number": "1497030118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17735 S WILLIAMSBURG DR",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605868636",
            "telephone_number": "630-643-3886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 S BOLINGBROOK DR",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604403411",
            "telephone_number": "630-226-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "EMILY",
        "middle_name": "ELISE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-13",
        "last_updated": "2013-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085004165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "085004165",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jasyl Medical Services
• JBH Medical Corporation LTD
• JCB Home Health Care Services Inc
• Jean Miller Counseling Center LLC
• Katrina N Jefferson
• Othman A. Jibril, DO
• Jilada B. Williams, DDS, PC
• Alma Jimenez
• Smita Ketan Jobanputra, M.D.
• Angela John

• Medical Physician Assistant in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.