Individual
JOLANTA PENTALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4025 N 92ND ST, WAUWATOSA, WI 53222-1613
(414) 358-5420
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
49541
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0-604-031-5
ECFMG
—
05
—
34764000
—
WI
Enumeration date
08/13/2006
Last updated
10/23/2025
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