Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Elias Bousheh

Individual provider Athletic Trainer · NPI 1902376239

Elias Bousheh is a Physical Therapist in Private Practice in Decatur, Illinois. Qualified in 2023, 3 years ago. Practices with Ivyrehab Physical Therapy, Occupational Therapy and Speech Language PA, a 385-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
3
Licensed in
IL
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

5255 E Maryland St
Decatur, IL 62521-9705
Phone: (217) 864-1264
Fax: (217) 864-1828
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 070027717 (IL)
Athletic Trainer Taxonomy 2255A2300X

Record details

NPI number1902376239
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 29, 2018
Last updated in NPPESSeptember 15, 2023
Certification dateSeptember 15, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Ivyrehab Physical Therapy, Occupational Therapy And Speech Language Pa — 385 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Decatur