{
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"EIN": null,
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"IsOrgSubpart": "N",
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"ParentOrgTIN": null,
"OrgName": "HECTOR L. SALCEDO M.D. S.C.",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"FirstLineMailingAddress": "4455 MADISON ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SKOKIE",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60076-2628",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "773-227-3132",
"MailingAddressFaxNumber": "773-227-3309",
"FirstLinePracticeLocationAddress": "3132 W NORTH AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CHICAGO",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60647-8415",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "773-227-3132",
"PracticeLocationAddressFaxNumber": "773-227-3309",
"EnumerationDate": "01/07/2013",
"LastUpdateDate": "01/07/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SALCEDO",
"AuthorizedOfficialFirstName": "HECTOR",
"AuthorizedOfficialMiddleName": "L",
"AuthorizedOfficialTitle": "FAMILY PRACTITIONER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "773-227-3132",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "036128912",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}