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

Zack Shaw, DPT

Individual provider Physical Therapist · NPI 1154848034

Zack Shaw, DPT is a Physical Therapist in Private Practice in Decatur, Illinois. Qualified in 2017, 9 years ago. Practices with Ivyrehab Physical Therapy, Occupational Therapy and Speech Language PA, a 385-clinician group and accepts Medicare assignment. Licensed in Illinois and Wisconsin.

Years since qualifying
9
Licensed in
IL, WI
In the registry since
2017
Specialties on file
2
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

4855-57 E 36
Decatur, IL 62521
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 070023183 (IL)
Physical Therapist Taxonomy 225100000X · Licence 14709 (WI)

Record details

NPI number1154848034
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorYes
NPI enumeratedAugust 23, 2017
Last updated in NPPESJune 25, 2019
Mailing address725 Montgomery Ln, Decatur, IL 62526-1268

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2017 (9 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

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