Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Shane C. Fogo, MD

Individual provider Family Medicine Physician · NPI 1063446318

Dr. Shane C. Fogo, MD is a Family Practice in Eureka, Illinois. Graduated from University of Illinois College of Med (CHI/PEOR/ROCK/Chm-Urb) in 2002, 24 years ago. Practices with Carle Eureka Hospital, an 11-clinician group. Licensed in Illinois.

Years since qualifying
24
Trained at
University of Illinois College of Med (CHI/PEOR/ROCK/Chm-Urb)
Licensed in
IL
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

105 S Major St
Eureka, IL 61530-1246
Phone: (309) 467-4691
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 036111674 (IL)

Record details

NPI number1063446318
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 11, 2006
Last updated in NPPESDecember 14, 2012

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated 2002 (24 years in practice)
Group practice Carle Eureka Hospital — 11 clinicians
Accepts Medicare assignment Not indicated

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