| Zack Shaw, DPT | |
|
4855-57 East 36, Decatur, IL 62521 | |
| (217) 864-1264 | |
| (217) 864-1828 |
| Full Name | Zack Shaw |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist In Private Practice |
| Experience | 9 Years |
| Location | 4855-57 East 36, Decatur, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154848034 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 14709 (Wisconsin) | Secondary |
| 225100000X | Physical Therapist | 070023183 (Illinois) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ivyrehab Physical Therapy Pllc | 7012997638 | 306 |
| Provider Name | Decatur Orthopedic Center Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1336586114 PECOS PAC ID: 4981844289 Enrollment ID: O20130710000446 |
| Provider Name | Ivyrehab Physical Therapy Pllc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1376917187 PECOS PAC ID: 7012997638 Enrollment ID: O20160304000277 |
| Mailing Address | Practice Location Address |
|---|---|
| Zack Shaw, DPT 725 Montgomery Ln, Decatur, IL 62526-1268 Ph: (217) 412-2302 | Zack Shaw, DPT 4855-57 East 36, Decatur, IL 62521 Ph: (217) 864-1264 |
Jaclyn Nicole Kleman, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2300 N Edward St, Decatur, IL 62526 Phone: 217-876-2600 Fax: 217-876-2615 | |
Don Michael Kyle Sr., P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3122 Brettwood Cir, Decatur, IL 62526 Phone: 217-876-4600 | |
Jaycee Cabalatungan Cristales, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 136 S Dipper Ln, Decatur, IL 62522 Phone: 217-428-7767 | |
Mrs. Elizabeth Komnick, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2300 N. Edward St., Decatur, IL 62526 Phone: 217-876-2600 Fax: 217-876-2615 | |
Mrs. Linda Sue Miller I, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2300 N Edward St, Decatur, IL 62526 Phone: 217-876-8121 Fax: 217-876-2261 | |
Kayla Rose, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 3785 N Water St, Decatur, IL 62526 Phone: 217-675-7111 | |
Morgan Belskamper, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2300 N Edward St, Decatur, IL 62526 Phone: 217-876-2600 |