Shane T Stachura, PT, MPT
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?
Practice location Address checks out
510 Prairie LnCissna Park, IL 60924-9710
Phone: (815) 457-2006
Fax: (815) 457-2016
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physical Therapist (primary) | Taxonomy 225100000X |
|---|
Record details
| NPI number | 1013154350 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | PT , MPT |
| Sole proprietor | No |
| NPI enumerated | January 8, 2009 |
| Last updated in NPPES | February 20, 2024 |
| Certification date | February 20, 2024 |
Medicare enrollment
| Medicare specialty | PHYSICAL THERAPIST IN PRIVATE PRACTICE |
|---|---|
| Medical school | OTHER |
| Graduated | 2013 (13 years in practice) |
| Group practice | Gibson Community Hospital Association — 159 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 7 on file with Medicare |
Other providers in Cissna Park
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Gibson Community Hospital Association
510 Prairie Ln Unit C, Cissna Park, IL 60924-9704 · (815) 457-2006