Provider Demographics
NPI:1972005452
Name:KASTLER, SHAINA MARIE (ATC, OTC)
Entity Type:Individual
Prefix:
First Name:SHAINA
Middle Name:MARIE
Last Name:KASTLER
Suffix:
Gender:F
Credentials:ATC, OTC
Other - Prefix:
Other - First Name:SHAINA
Other - Middle Name:MARIE
Other - Last Name:OCONNOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:1952 ABERDEEN COURT
Mailing Address - Street 2:
Mailing Address - City:SYCAMORE
Mailing Address - State:IL
Mailing Address - Zip Code:60178-3175
Mailing Address - Country:US
Mailing Address - Phone:815-758-0000
Mailing Address - Fax:815-748-8091
Practice Address - Street 1:2111 MIDLANDS COURT
Practice Address - Street 2:
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178
Practice Address - Country:US
Practice Address - Phone:815-758-0000
Practice Address - Fax:815-748-8091
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-01
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0960030232255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer