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General NPI Number Information
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NPI Number | 1376917187
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Entity Type | Organization
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Legal Business Name | IVYREHAB PHYSICAL THERAPY, OCCUPATIONAL THERAPY & SPEECH LANGUAGE PATH
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Dates
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Enumeration Date | 11/17/2015
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 204 E WASHINGTON ST
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City | CLINTON
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State | IL
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Zip | 61727-1715
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Country | US
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Telephone | 217-570-0225
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Fax | 217-570-0227
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Provider Business Mailing Address
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Address Line | PO BOX 416501
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City | BOSTON
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State | MA
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Zip | 02241-7594
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Country | US
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Telephone | 914-294-4050
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Fax |
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Authorized Official
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Title or Position | SR. DIRECTOR OF PROVIDER RELATIONS
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Name | ASHLEY GRIFFITHS
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Credential |
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Telephone | 914-294-4050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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