| Dr Shane C Fogo, MD | |
|
105 S Major St, Eureka, IL 61530-1246 | |
| (309) 467-4691 | |
| Not Available |
| Full Name | Dr Shane C Fogo |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 23 Years |
| Location | 105 S Major St, Eureka, Illinois |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063446318 | NPI | - | NPPES |
| 036111674 | Medicaid | IL | |
| 10215111 | Other | IL | BCBS TCH |
| 5715395 | Other | IL | BCBS HPT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036111674 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Advocate Eureka Hospital | Eureka, IL | Hospital |
| Advocate Bromenn Medical Center | Normal, IL | Hospital |
| Saint Francis Medical Center | Peoria, IL | Hospital |
| Methodist Medical Center Of Illinois | Peoria, IL | Hospital |
| Apostolic Christian Home Of Eureka | Eureka, IL | Nursing home |
| Apostolic Christian Home | Roanoke, IL | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Carle Eureka Hospital | 3870914393 | 10 |
| Entity Name | Advocate Health And Hospitals Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700824455 PECOS PAC ID: 7810800935 Enrollment ID: O20031106000064 |
| Entity Name | Carle West Physician Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467074138 PECOS PAC ID: 8921420308 Enrollment ID: O20200613000147 |
| Entity Name | Carle Bromenn Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104442615 PECOS PAC ID: 8921429499 Enrollment ID: O20200716000187 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Shane C Fogo, MD 701 Lee St, Suite 300, Des Plaines, IL 60016-4539 Ph: (847) 390-5900 | Dr Shane C Fogo, MD 105 S Major St, Eureka, IL 61530-1246 Ph: (309) 467-4691 |
Dr. Christopher R. Hughes, M.D. Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 105 S Major St, Eureka, IL 61530 Phone: 309-467-4691 Fax: 309-467-6229 | |
Nicholas Weber, DO Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 105 S Major St, Eureka, IL 61530 Phone: 309-467-4691 | |
Dr. David L. Miller, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 105 S Major St, Eureka, IL 61530 Phone: 309-467-4691 Fax: 309-467-6229 | |
Dr. Steven K. Jones, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 105 S Major St, Eureka, IL 61530 Phone: 309-467-4691 Fax: 309-467-6229 | |
Dr. Keith E. Knepp, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 105 S Major St, Eureka, IL 61530 Phone: 309-467-4691 Fax: 309-467-6229 |