# IVYREHAB WISCONSIN PEDS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316636210
- **Authorized official:** ASHLEY GRIFFITHS (DIRECTOR OF PAYER RELATIONS)
- **Authorized official phone:** (914) 294-4050

## Contact information

- **Practice address:** 19601 W BLUEMOUND RD STE 120, BROOKFIELD, WI 53045-5974
- **Practice address phone:** (262) 771-0065
- **Mailing address:** 1311 MAMARONECK AVE STE 140, WHITE PLAINS, NY 10605-5224

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 05/05/2023
- **Last updated:** 11/03/2025