IndividualActive
Shane Fogo, M.D.
NPI 1063446318 · Family Medicine Physician · Eureka, IL
Provider details
- NPI number
- 1063446318
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 036111674 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
105 S Major St
Eureka, IL 61530-1246
Phone: (309) 467-4691
Street-level locationGet directions
Mailing address
701 Lee St
Des Plaines, IL 60016-4539
Registry dates
- Enumerated
- 2006-07-11
- Last updated
- 2012-12-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.