Sarah Grace Rebban, SLP-CF
Individual provider Active NPI Speech-Language Pathologist · Rockford, IL
NPI 1760189807 · NPPES record last updated Feb 9, 2023
Key facts
- NPI
- 1760189807
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 242.007135 (IL)
- Practice address
- 4401 N Main St
Rockford, IL 61103-1293 - Phone
- (815) 921-9200
- NPI assigned
- Feb 9, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 28
Medicare Care Compare profile
- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aegis Group Practice LLC
Practice addresses (Care Compare)
3470 N Alpine Rd
Rockford, IL 61114-4802
Phone (815) 997-7919
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250502002468 | IL | Practitioner - Qualified Speech Language Pathologist | 3577080589 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 242.007135 | IL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aegis Group Practice LLC | Speech-Language Pathologist | Current |
Accepting new patients |
| Powerback Rehabilitation LLC | Speech-Language Pathologist | Current |
Accepting new patients |
| Powerback Rehabilitation LLC | Speech-Language Pathologist | Current |
Accepting new patients |
| Aegis Group Practice LLC | Speech-Language Pathologist | Current |
Accepting new patients |
Locations
4933 Old Greenwood Rd
Fort Smith, AR 72903
1920 Maple Ave
Lisle, IL 60532
Phone (630) 725-7000
3470 N Alpine Rd
Rockford, IL 61114
Phone (815) 668-7333
101 E State St
Kennett Square, PA 19348
Phone (610) 925-4436
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 242.007135 | IL | Yes |
Addresses
Primary practice location
4401 N Main St
Rockford, IL 61103-1293
Mailing address
13924 De la Tour Dr
Rockton, IL 61072-1690
Phone (815) 298-8326
Other practice location 1
3470 N Alpine Rd
Rockford, IL 61114-4802
Phone (815) 877-1441
Other providers in Rockford, IL
- Kadijah Sekhmet Ray
- Linda M Razbadouski
- Susan M. Razbadouski
- Mohammad Razvi
- Ready, Set, Play LLC
- Lester Walter Rebman
- Rebound Physical Therapy Center PC
- Laura Anne Recob
- Bridget Ann Reddy
- Elizabeth Lynn Redell
All providers in Rockford, IL · Speech-Language Pathologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.