Pentus Health Wylie LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PENTUS HEALTH WYLIE LLC

Practice address

448 Wylie Dr
Normal, IL 61761-5405

Phone

(844) 973-6887

NPI assigned

Mar 26, 2025

Last updated

Mar 26, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ivan Reyes

Title

Administrator

Phone

(352) 304-4109

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1742947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742947200000",
    "number": "1043012313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2273 LEE RD STE 101",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327897213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "448 WYLIE DR",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617615405",
            "telephone_number": "844-973-6887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENTUS HEALTH WYLIE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-26",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "352-304-4109"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jean Pe, MD
• Kennady Pearson
• Meredith Renee Peebles
• Marlon Pemberton
• Pentus Health Wylie Limited
• Ross David Percell, DO
• Kent Petersen, RN
• Jamie D Peterson, ST
• Kyle Petit, ATC
• Lacie Petro, M.D.

• Primary Care Clinic/Center in Normal, IL
• Providers in Normal, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.