Search › Illinois › 152W00000X
Nicole Jensen, OD
NPI 1790072924 · on the registry since 2011
Practice
- Address
- 1200 W Main St
Ste 21
Peoria, IL 61606 - Phone
- (309) 672-2273
- Fax
- (309) 672-2274
- Organisation at this address
- Highland Park Cvs, L.L.C.
Optim Dental Peoria-1 Llc
Access Dental Of Peoria Optim LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 7
Registry record
- Primary taxonomy
- 152W00000X
152W00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2014-07-10
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois