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Sandra Marie Pena

Family Medicine

Allopathic & Osteopathic Physicians

932 Lake St Ste 300, Oak Park, IL 60301-1204

PECOS Enrollment

This provider is enrolled in PECOS as SANDRA PENA.

Based on the most recent information from CMS, provider Sandra Marie Pena is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1932563996
Provider Type
Individual
Full Name
Pena, Sandra Marie
Credential
MD

Gender
Female
Sole Proprietor
No
Enumeration Date
4/6/2016
Last Updated
9/28/2023

Contact Information

Practice Location

932 Lake St Ste 300, Oak Park, IL 60301-1204

(331) 221-1700

(331) 221-2729

Mailing Location

932 Lake St Ste 300, Oak Park, IL 60301-1204

(331) 221-1700

(331) 221-2729

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 036.150456 Illinois

Sandra Marie Pena

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Kelly, Mary Louise

Kungl, Paul Anthony

Family Medical Care, Ltd

Schattauer, Paul C

Wholistic Health Center Of Oak Park, Inc.

Limperis, Makis G

Mccammon-Chase, Nathalie D

Hutton, Mary C

Duong, Hung

Hagenswiecicki, Matthew