# SHEPARD PAIN AND PERFORMANCE CARE PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Shepard Pain and Performance Care PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922396928
- **Authorized official:** DR. MATTHEW J SHEPARD D.C. (PRESIDENT)
- **Authorized official phone:** (815) 980-5706

## Contact information

- **Practice address:** 2 AIRLINE DR, SUITE 400, BLOOMINGTON, IL 61704-3433
- **Practice address phone:** (815) 980-5706
- **Mailing address:** 108 OAK CREEK PLZ APT 3-12, APT 3-12, BLOOMINGTON, IL 61704-7545
- **Mailing address phone:** (815) 980-5706

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NR0400X | Rehabilitation Chiropractor | 038011982 | IL | Yes |

## Other

- **Enumeration date:** 07/12/2011
- **Last updated:** 07/12/2011