Shane C Fogo (NPI# 1063446318, PAC ID# 2365408606) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1063446318 |
| PAC ID by PECOS | 2365408606 |
| Professional Enrollment ID | I20041208000245 |
| Full Name | Shane C Fogo |
| Organization Legal Name | ADVOCATE HEALTH AND HOSPITALS CORPORATION |
| Address |
101 S Major St Eureka IL 61530-1246 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF ILLINOIS AT CHICAGO HEALTH SCIENCE CENTER |
| Graduation Year | 2002 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 7810800935 |
| Number of Group Practice Members | 1681 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 141309 | ADVOCATE EUREKA HOSPITAL |
| 140067 | OSF SAINT FRANCIS MEDICAL CENTER |
| 140209 | METHODIST MEDICAL CENTER OF ILLINOIS |
| 140127 | ADVOCATE BROMENN MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 101 S Major St, Eureka, IL 61530-1246 | ADVOCATE HEALTH AND HOSPITALS CORPORATION | |
| 101 S Major St, Advocate Eureka Hospital, Eureka, IL 61530-1246 | 3092682172 | ADVOCATE HEALTH AND HOSPITALS CORPORATION |
| 105 S Major St, Eureka, IL 61530-1246 | 3093042600 | ADVOCATE HEALTH AND HOSPITALS CORPORATION |
| Organization Legal Name | ADVOCATE HEALTH AND HOSPITALS CORPORATION |
| Physicians | 1766 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sarah Renee Jorgenson | Internal Medicine | Advocate Health and Hospitals Corporation | 4025 N Western Ave, Chicago, IL 60618-3726 |
| Philip C Gutsell | Family Medicine | Advocate Health and Hospitals Corporation | 4600 N Ravenswood Ave, Chicago, IL 60640-4510 |
| Jaclyn Catanese | Nurse Practitioner | Advocate Health and Hospitals Corporation | 1425 N Randall Rd, Elgin, IL 60123-2300 |
| Michael John Duchaj | Physical Therapy | Advocate Health and Hospitals Corporation | 13900 Quality Dr, Huntley, IL 60142-8098 |
| Andrea Pawlak | Nurse Practitioner | Advocate Health and Hospitals Corporation | 4740 W 95th St, Oak Lawn, IL 60453-2530 |
| Mandy Fila | Registered Dietitian Or Nutrition Professional | Advocate Health and Hospitals Corporation | 2210 W 95th St, Chicago, IL 60643-1002 |
| Ilia Rosa Sumoza | Hematology/oncology | Advocate Health and Hospitals Corporation | 2622 83rd St, Darien, IL 60561-1661 |
| Lara K Nicol | Family Medicine | Advocate Health and Hospitals Corporation | 2511 N Kedzie Blvd, Chicago, IL 60647-2603 |
| Julieta Lasala | Family Medicine | Advocate Health and Hospitals Corporation | 100 W 162nd St, Advocate Medical Group South Holland, South Holland, IL 60473-2003 |
| Kelly L Perisin | Nurse Practitioner | Advocate Health and Hospitals Corporation | 910 N Rand Rd, Lake Zurich, IL 60047-3201 |
| Street Address |
101 S MAJOR ST |
| City | EUREKA |
| State | IL |
| Zip | 61530-1246 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher R Hughes | Family Medicine | Advocate Health and Hospitals Corporation | 101 S Major St, Eureka, IL 61530-1246 |
| Brian Shore | Physician Assistant | Central Illinois Orthopedic Surgery II LLC. | 101 S Major St, Eureka, IL 61530-1246 |
| David L Miller | Family Medicine | Advocate Health and Hospitals Corporation | 101 S Major St, Eureka, IL 61530-1246 |
| Christie L Rocke | Nurse Practitioner | Advocate Health and Hospitals Corporation | 101 S Major St, Eureka, IL 61530-1246 |
| Amit S Parkhe | Nurse Practitioner | Advocate Health and Hospitals Corporation | 101 S Major St, Advocate Eureka Hospital, Eureka, IL 61530-1246 |
| Ricardo Vallejo | Pain Management | Millennium Pain Center LLC | 101 S Major St, Eureka, IL 61530-1246 |
| Clark Anderson Ii | Physician Assistant | Illinois Gastroenterology Institute S C | 101 S Major St, Eureka, IL 61530-1246 |
| Donald E Penn Jr. | Gastroenterology | Illinois Gastroenterology Institute S C | 101 S Major St, Eureka, IL 61530-1246 |
| Steven K Jones | Family Medicine | Advocate Health and Hospitals Corporation | 101 S Major St, Eureka, IL 61530-1246 |
| Connor T Schuler | Physician Assistant | Illinois Gastroenterology Institute S C | 101 S Major St, Eureka, IL 61530-1246 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Vijay Laxmi Misra | Gastroenterology | Digestive Disease Consultants Ltd | 101 S Major, Eureka, IL 61530-1246 |
| Scott C Oconnor | Podiatry | 105 S Major, Eureka, IL 61530-1246 | |
| Steven C Ingalsbe | Family Medicine | Advocate Health and Hospitals Corporation | 101 S Major St, Eureka, IL 61530-1246 |
| Kerry M Maloney | Nurse Practitioner | Illinois Gastroenterology Institute S C | 101 S Major St, Eureka, IL 61530-1246 |
| Sharon L Moy | Family Practice | Advocate Health and Hospitals Corporation | 101 S Major St, Eureka, IL 61530-1246 |
| Joseph S. Borreggine | Podiatry | Preferred Podiatry Group PC | 610 W Cruger Ave, Eureka, IL 61530-1329 |
| Carrie A Musselman | Chiropractic | Preferred Care Medical Center Ltd | 1932 S Main St, Eureka, IL 61530-1666 |
| Joy C Schramm | Nurse Practitioner | Preferred Care Medical Center Ltd | 1932 S Main St, Eureka, IL 61530-1666 |
| Todd W Gander | Chiropractic | Preferred Care Medical Center Ltd | 1932 S Main St, Eureka, IL 61530-1666 |
| Amanda K Krutke | Certified Clinical Nurse Specialist (cns) | Preferred Care Medical Center Ltd | 1932 S Main St, Eureka, IL 61530-1666 |
| Find all physicians in zip 61530 | |||
| City | EUREKA |
| Zip Code | 61530 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | EUREKA + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Shane C Fogo.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.