Healthcare Provider Details

I. General information

NPI: 1255249579
Provider Name (Legal Business Name): PENA CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 S YORK RD
BENSENVILLE IL
60106-2631
US

IV. Provider business mailing address

440 S YORK RD
BENSENVILLE IL
60106-2631
US

V. Phone/Fax

Practice location:
  • Phone: 630-521-9700
  • Fax: 630-521-9797
Mailing address:
  • Phone: 630-521-9700
  • Fax: 630-521-9797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ALVARO ENRIQUE PENA
Title or Position: OWNER
Credential: MD
Phone: 630-521-9700