Provider Demographics
NPI:1841800083
Name:MCILROY, LYDIA (PT, DPT)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:
Last Name:MCILROY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7241 S MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD TWP
Mailing Address - State:OH
Mailing Address - Zip Code:44077-2232
Mailing Address - Country:US
Mailing Address - Phone:814-806-6092
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-9207
Practice Address - Country:US
Practice Address - Phone:216-444-6262
Practice Address - Fax:216-444-8548
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT018729225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist