Individual
INNA IALAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
6811 118TH AVE, KENOSHA, WI 53142-8420
(262) 857-5750
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8603-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100396885
—
WI
Enumeration date
12/17/2025
Last updated
03/10/2026
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