{
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"FirstLineMailingAddress": "PO BOX 388320",
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"MailingAddressCityName": "CHICAGO",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60638-8320",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "773-767-4600",
"MailingAddressFaxNumber": "773-767-8320",
"FirstLinePracticeLocationAddress": "676 N SAINT CLAIR ST",
"SecondLinePracticeLocationAddress": "SUITE 1525",
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"PracticeLocationAddressTelephoneNumber": "312-337-1556",
"PracticeLocationAddressFaxNumber": "312-266-0478",
"EnumerationDate": "07/16/2006",
"LastUpdateDate": "08/26/2009",
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"NPIReactivationDate": null,
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"Gender": null,
"AuthorizedOfficialLastName": "GOLDSTEIN",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Gastroenterology Physician",
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"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}