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

Shane T Stachura, PT, MPT

Individual provider Physical Therapist · NPI 1013154350

Shane T Stachura, PT, MPT is a Physical Therapist in Private Practice in Cissna Park, Illinois. Qualified in 2013, 13 years ago. Practices with Gibson Community Hospital Association, a 159-clinician group and accepts Medicare assignment.

Years since qualifying
13
In the registry since
2009
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
MPT — Master of Physical Therapy
The master's-level physical therapy degree awarded before the DPT became standard.

See every abbreviation used in this directory →

Practice location Address checks out

510 Prairie Ln
Cissna Park, IL 60924-9710
Phone: (815) 457-2006
Fax: (815) 457-2016
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1013154350
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , MPT
Sole proprietorNo
NPI enumeratedJanuary 8, 2009
Last updated in NPPESFebruary 20, 2024
Certification dateFebruary 20, 2024

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Gibson Community Hospital Association — 159 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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