Dane Jeffrey Shepherd, D.O.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

036.056894 Issued in IL

Practice address

17 N Wabash Ave Ste 678
Chicago, IL 60602

Phone

(312) 782-9153

NPI assigned

Jan 30, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2016 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Osteopathy Chicago, LTD.

  • General Practice Physician
  • Chicago, IL
  • NPI 1720526890
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1891831483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 HASSELL RD",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601692602",
            "telephone_number": "312-782-9153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 N WABASH AVE STE 678",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60602",
            "telephone_number": "312-782-9153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17 N Wabash Ave Ste 678",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60602",
            "country_code": "US",
            "telephone_number": "312-782-9153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "DANE",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036.056894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "OsteopathyChicago@gmail.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "business email",
            "address_1": "17 N Wabash Ave Ste 678",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606024878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Frederick Cary Shepard, LPC
• Janice Tucker Shepard, MS,CCC,SLP -L
• Kirk Van Shepard II, MD, MS
• Myrtise Shepard
• Rebekah S. Shephard, APRN
• Danielle Shepherd, MD
• David Shepherd
• Emily Anne Shepherd, MD
• Jerry Shepherd, MD
• Richard F Shepherd, LCSW

• General Practice Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.