Lee William Fruson, MD

Primary specialty

Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X

License

125.077332 Issued in IL

Practice address

1161 W. Harrison St
Ste: 400
Chicago, IL 60612

Phone

(312) 432-2300

Fax

(708) 409-5179

NPI assigned

Jun 14, 2021

Reactivated

Oct 26, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1508434903",
    "addresses": [
        {
            "country_code": "CA",
            "country_name": "Canada",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "1-1528 29TH AVENUE SW",
            "city": "CALGARY",
            "state": "ALBERTA",
            "postal_code": "T2T IM3"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 W. HARRISON ST",
            "address_2": "STE: 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-432-2300",
            "fax_number": "708-409-5179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRUSON",
        "first_name": "LEE",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "deactivation_date": "2021-09-13",
        "reactivation_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "IL",
            "license": "036.158462",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "IL",
            "license": "125.077332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Fruin, PA-C, PT
• Dennis Fruin, RPH
• Douglass R. Fruin, OD
• Robert Daniel Fruin, MD
• M. Yvette Fruscione, MS, LCPC
• Arch Tamayo Fruylan, P.T.
• Alexandra T Fry
• Brett W Fry, PSY.D.
• Colin M E Fry, MD
• Deborah Fry, L.C.P.C.

• Adult Reconstructive Orthopaedic Surgery Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Adult Reconstructive Orthopaedic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; 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.