MEDICARE: SHAUN WHEELER DPT, PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	070.018806	IL

General Provider Information

NPI Number	:	1285972000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAUN WHEELER DPT, PT

Provider Business Mailing Address
First Line	:	2001 BUTTERFIELD RD STE 1600
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1211
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1275 N CONVENT ST STE 3
Second Line	:
City	:	BOURBONNAIS
State	:	IL
Zip	:	60914-8211
Country	:	US
Telephone Number	:	815-936-1855
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2013
Last Update Date	:	12/02/2025

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