Pentom Health Services LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

PENTOM HEALTH SERVICES LLC

Practice address

516 Grant St
Downers Grove, IL 60515-3024

Phone

(630) 413-1303

Fax

(888) 311-3015

NPI assigned

Aug 14, 2023

Last updated

Aug 14, 2023By 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

Marcia Radja, FNPNPI 1164776670

Title

Ceo

Phone

(312) 420-5494

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marcia Radja, APN

  • Family Nurse Practitioner
  • Downers Grove, IL
  • NPI 1164776670
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691971200000",
    "number": "1366125536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 GRANT ST",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605153024",
            "telephone_number": "630-413-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 GRANT ST",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605153024",
            "telephone_number": "630-413-1303",
            "fax_number": "888-311-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENTOM HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-14",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-13",
        "status": "A",
        "authorized_official_last_name": "RADJA",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "312-420-5494",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric and Adolescent Healthy Lifestyle Center, LLC
• Pediatric Rehabilitation Services
• Natalie Amanda Pekala
• Chad Pendley, M.D.
• Lauren Elizabeth Penkas
• Eileen Pentony, MD
• Pamela Marie Peoples
• Rebecca Perehudoff Minton, MA, ATR, LCPC
• Raul Antonio Perez Lopez
• Paula Dey Perone, CCC-MS, SLP

• Family Nurse Practitioner in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.