{
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"IsOrgSubpart": "N",
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"OrgName": "DERMATOLOGY-CHICAGO S C",
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"NamePrefix": null,
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"FirstLineMailingAddress": "25 E WASHINGTON ST",
"SecondLineMailingAddress": "SUITE 1131",
"MailingAddressCityName": "CHICAGO",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60602-1708",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "312-372-0150",
"MailingAddressFaxNumber": "312-372-4249",
"FirstLinePracticeLocationAddress": "25 E WASHINGTON ST",
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"PracticeLocationAddressTelephoneNumber": "312-372-0150",
"PracticeLocationAddressFaxNumber": "312-372-4249",
"EnumerationDate": "11/18/2009",
"LastUpdateDate": "12/02/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHANKER",
"AuthorizedOfficialFirstName": "DAVID",
"AuthorizedOfficialMiddleName": "BRYAN",
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"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "312-372-0150",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207N00000X",
"TaxonomyName": "Dermatology Physician",
"LicenseNumber": "036064577",
"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."
}
}
}
}