Healthcare Provider Details
I. General information
NPI: 1780751149
Provider Name (Legal Business Name): COMMUNITY REHAB OF IOWA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/29/2006
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3111 GORDON DRIVE
SIOUX CITY IA
51106
US
IV. Provider business mailing address
2001 BUTTERFIELD RD STE 1600
DOWNERS GROVE IL
60515-1211
US
V. Phone/Fax
- Phone: 712-277-0507
- Fax: 712-277-0456
- Phone: 630-296-2222
- Fax: 630-759-9510
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | IA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | IA |
VIII. Authorized Official
Name:
WADE
A
MEYER
Title or Position: VP CHIEF COMPLIANCE OFFICER
Credential:
Phone: 630-296-2223