Active NPI
Fraterno Lemus, M. D.
- Neurology Physician
- Orland Park, IL
National Provider Identifier
1114969904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 036-054981
- Practice address
- 14532 John Humphrey Dr
Orland Park, IL 60462-2640 - Phone
- (708) 460-5403
- Fax
- (708) 460-0670
- NPI assigned
- Jun 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 036-054981 | IL | Primary |
| Clinical Neurophysiology Physician | 2084N0600X | 036-054981 | IL |
Addresses
Primary practice location
14532 John Humphrey Dr
Orland Park, IL 60462-2640
Mailing address
14532 John Humphrey Dr
Orland Park, IL 60462-2640
Phone (708) 460-5403
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 130023926 | Other | IL | RAILROAD MEDICAREPALMETTO |
| 036054981 | Medicaid | IL | |
| 205923 | Other | IL | UNITED HEALTH |
| 216-07098-34 | Other | IL | BLUECROSSBLUESHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-054981 | IL | MD | Clinical Neurophysiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McDermott Podiatry of Joliet PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Foot & Ankle Surgery Podiatrist
- Orland Park, IL
- NPI 1598068850
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213142400000",
"number": "1114969904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14532 JOHN HUMPHREY DR",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604622640",
"telephone_number": "708-460-5403",
"fax_number": "708-460-0670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14532 JOHN HUMPHREY DR",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604622640",
"telephone_number": "708-460-5403",
"fax_number": "708-460-0670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEMUS",
"first_name": "FRATERNO",
"name_prefix": "Dr.",
"credential": "M. D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-13",
"last_updated": "2008-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "IL",
"license": "036-054981",
"primary": true
},
{
"code": "2084N0600X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Clinical Neurophysiology",
"state": "IL",
"license": "036-054981",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICAREPALMETTO",
"identifier": "130023926",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036054981",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH",
"identifier": "205923",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSSBLUESHIELD",
"identifier": "216-07098-34",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Orland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.