Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHANE T STACHURA, PT, MPT
ActiveSHANE T STACHURA, PT, MPT is a Physical Therapy Assistant healthcare provider located in CISSNA PARK, Illinois. NPI 1013154350 is currently active in the NPPES registry. Verify at CMS.
Physical Therapy Assistant · CISSNA PARK, IL
Registration Details
- NPI Number
- 1013154350
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 8, 2009 (17.602078105254 yrs)
- Last Updated
- Feb 20, 2024
Practice Information
- Address
-
510 PRAIRIE LNCISSNA PARK, IL, 609249710Browse IL providers · Browse ZIP 60924
- Phone
- 8154572006
- Fax
- 8154572016
- Primary Specialty
-
Physical Therapy Assistant
225100000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.