CRYSTAL A SHANNON (PT, DPT) – Physical Therapist, NPI 1306039508

CRYSTAL A SHANNON (PT, DPT) is a healthcare provider. based in Morton grove, Illinois. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. 070.025693 (IL). The NPI Number for CRYSTAL A SHANNON (PT, DPT) is 1306039508

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
CRYSTAL A SHANNON (PT, DPT)
NPI
1306039508
Phone
(847) 324-3976
Address
8930 WAUKEGAN RD
Enumeration Date
21 August 2007
Last Update Date
3 June 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7084829320
Graduation Year
2020 (6 years ago)
PAC ID
6901214287
Group Practice PAC ID
4789602681
Professional Enrollment ID
I20210427000721
Address ID
IL605265623LA407XXRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness75
Years active:18State licenses:1Digital endpointsOther names

5,028 PHYSICAL THERAPIST IN PRIVATE PRACTICE in IL

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Provider Addresses for CRYSTAL A SHANNON (PT, DPT)

  • Waukegan Road, Morton Grove, Niles Township, Cook County, Illinois, 60029, United States

    SUITE 200

    MORTON GROVE, IL 600532126

    Phone: (847) 324-3976

    Type: Mailing

  • 150, North River Road, Des Plaines, Cook County, Illinois, 60016, United States

    SUITE 100

    DES PLAINES, IL 600161272

    Phone: (847) 954-7646

    Type: Location

  • 320 BUSSE HWY

    PARK RIDGE, IL 600683251

    Phone: (847) 268-0800

    Fax: (847) 268-0801

    Type: Location

  • 2122 YORK RD STE 300

    OAK BROOK, IL 605231925

    Phone: (630) 575-1980

    Fax: (630) 928-5080

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-04-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210427000721IPhysical Therapist In Private PracticeILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60053)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4789602681View full group profile
NameSpecialtyState
-IL
Physical Therapist In Private PracticeIL
-IL
-IL
Physical Therapist In Private PracticeVA
-MI
-IL
Physical Therapist In Private PracticeAZ
Physical Therapist In Private PracticeIL
-MI

Reviews

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Frequently asked questions

How do payers reference CRYSTAL A SHANNON (PT, DPT)?
For CRYSTAL A SHANNON (PT, DPT), use NPI 1306039508 as the unique 10-digit identifier.
Would CRYSTAL A SHANNON (PT, DPT) appear as active to a payer?
You can treat CRYSTAL A SHANNON (PT, DPT) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe CRYSTAL A SHANNON (PT, DPT)'s focus?
For CRYSTAL A SHANNON (PT, DPT), the primary taxonomy reads as Physical Therapist. Clinical services aligned with this taxonomy classification.
Where in Illinois is CRYSTAL A SHANNON (PT, DPT) registered?
Use Morton Grove, Illinois as the headline location for CRYSTAL A SHANNON (PT, DPT) here.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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