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Individual

DR. DOUGLASS R. FRUIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
2736 N CLARK ST, CHICAGO, IL 60614-1503
(773) 248-8866
Mailing address
1825 N WINNEBAGO AVE APT 203, CHICAGO, IL 60647-6322
(308) 380-7558

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.011575
IL
152W00000X
Optometrist
1467
NE

Other

Enumeration date
06/20/2017
Last updated
12/21/2021
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