{
"Npi": {
"NPI": "1043457302",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GUTSTEIN",
"FirstName": "SUSAN",
"MiddleName": "LYNN",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "OTR/L",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "755 SKOKIE BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NORTHBROOK",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60062-2805",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "312-238-3813",
"MailingAddressFaxNumber": "847-412-6440",
"FirstLinePracticeLocationAddress": "755 SKOKIE BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NORTHBROOK",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60062-2805",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "312-238-3813",
"PracticeLocationAddressFaxNumber": "847-412-6440",
"EnumerationDate": "01/08/2009",
"LastUpdateDate": "01/08/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225X00000X",
"TaxonomyName": "Occupational Therapist",
"LicenseNumber": "056001912",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}