Form and Function PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

FORM AND FUNCTION PLLC

Practice address

1512 N Fremont St Ste 104
Chicago, IL 60642-2567

Phone

(815) 217-4964

NPI assigned

Jun 1, 2026

Last updated

Jun 1, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Shane Getald McTague, DCNPI 1497529218

Title

Owner

Phone

(815) 217-4964

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shane Gerald McTague, DC

  • Chiropractor
  • Chicago, IL
  • NPI 1497529218
  NPD Authorized official

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

{
    "created_epoch": "1780272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780272000000",
    "number": "1255263554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 N FREMONT ST STE 104",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606422567",
            "telephone_number": "815-217-4964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 N FREMONT ST STE 104",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606422567",
            "telephone_number": "815-217-4964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORM AND FUNCTION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-01",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A",
        "authorized_official_last_name": "MCTAGUE",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "GETALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-217-4964",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald D Forgue, QMHP
• Kelsey Forier
• Beth Forir
• Michele Forjette, M.A., L.C.P.C.
• Hawa Bindu Forkpa
• Edward Forman, DO
• Karyn Beth Forman, L.AC.
• Margaret Forman, PA-C
• Louis Joseph Formica, PH.D.
• Carla Formoso Pico, MD

• Chiropractor in Chicago, IL
• Providers in Chicago, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.