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General NPI Number Information
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NPI Number | 1922973973
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Entity Type | Organization
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Legal Business Name | IVY INFUSION PROFESSIONAL NURSING SERVICES LLC
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Dates
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Enumeration Date | 10/09/2025
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 9601 N CENTENNIAL DRIVE 3RD FLOOR
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City | MUNSTER
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State | IN
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Zip | 46321
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Country | US
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Telephone | 708-858-0360
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Fax |
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Provider Business Mailing Address
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Address Line | 9601 N CENTENNIAL DRIVE 3RD FLOOR
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City | MUNSTER
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State | IN
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Zip | 46321-4375
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REGISTERED NURSE/DIRECTOR
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Name | ASHLEY MONTGOMERY
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Credential |
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Telephone | 708-858-0360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number |
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License Number State |
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