Pentus Healtth Wabash LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PENTUS HEALTTH WABASH LLC

Practice address

111 N Wabash Ave Ste 620
Chicago, IL 60602-1914

Phone

(352) 304-4109

NPI assigned

Mar 26, 2025

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

Locations

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": "1265234579",
    "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",
            "telephone_number": "352-304-4109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N WABASH AVE STE 620",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021914",
            "telephone_number": "352-304-4109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENTUS HEALTTH WABASH 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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Celeste Pensamiento
• Jay Michael Pensler, M.D.
• Debra Suzann Pentangelo, LCSW
• Michael Pentangelo, LCSW
• Tara Lane Pentoney, RD,LDN
• Anastasiya Pentya, PA-C
• Sudhir Penugonda, M.D.
• Leena Sai Penumalee, MD
• Mouna Penumarthy
• Sarah Love Penzell

• Primary Care Clinic/Center in Chicago, IL
• Providers in Chicago, 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.