Individual
JERRY SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 S PAULINA ST STE 440, CHICAGO, IL 60612-3806
(312) 942-5495
Mailing address
600 S PAULINA ST STE 440, CHICAGO, IL 60612-3806
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
125087805
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/10/2025
Last updated
06/10/2026
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