Active NPI
Lily Arnold
- Speech-Language Pathologist
- Bloomington, IL
National Provider Identifier
1194456517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 242006715
- Practice address
- 2103 N Veterans Pkwy Ste 328
Bloomington, IL 61704-0919 - Phone
- (309) 948-6469
- NPI assigned
- Jun 17, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 242006715 | IL | Primary |
Addresses
Primary practice location
2103 N Veterans Pkwy Ste 328
Bloomington, IL 61704-0919
Mailing address
PO Box 416501
Boston, MA 02241-7594
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 242006715 | IL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Medicine & Rehabilitation Physician
- New York, NY
- NPI 1215637699
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728518400000",
"number": "1194456517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 416501",
"city": "BOSTON",
"state": "MA",
"postal_code": "022417594"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2103 N VETERANS PKWY STE 328",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617040919",
"telephone_number": "309-948-6469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARNOLD",
"first_name": "LILY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-17",
"last_updated": "2024-10-10",
"certification_date": "2024-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "242006715",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.