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

Kelly A Shaw, DPT

Individual provider Physical Therapist · NPI 1124759154

Kelly A Shaw, DPT is a Physical Therapist in Private Practice in Lockport, Illinois. Qualified in 2022, 4 years ago. Practices with Athletico Ltd, a 2,186-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
4
Licensed in
IL
In the registry since
2022
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

1147 E 9th St
Lockport, IL 60441-3219
Phone: (815) 834-9901
Fax: (815) 834-9904
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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 070026729 (IL)

Record details

NPI number1124759154
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPT
Sole proprietorNo
NPI enumeratedJune 21, 2022
Last updated in NPPESJuly 11, 2022
Certification dateJuly 11, 2022
Mailing address2122 York Rd Ste 300, Oak Brook, IL 60523-1925

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Athletico Ltd — 2186 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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