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1053150557 NPI number — ABIGAIL ELIZABETH CASMERE

NPI Number: 1053150557
Health Care Provider/Practitioner: ABIGAIL ELIZABETH CASMERE

Information about “1053150557” NPI (ABIGAIL ELIZABETH CASMERE) exists in 1053150557 in HTML format HTML  |  1053150557 in plain Text format TXT  |  1053150557 in PDF (Portable Document Format) PDF  |  1053150557 in an XML format XML  formats.

NPI Number : 1053150557 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1053150557",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CASMERE",
    "FirstName": "ABIGAIL",
    "MiddleName": "ELIZABETH",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "6619 WALNUT GROVE CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DOWNERS GROVE",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60516-3035",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "630-796-1483",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "931 E 86TH ST STE 104",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "INDIANAPOLIS",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "46240-1852",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "317-257-1484",
    "PracticeLocationAddressFaxNumber": "317-257-1488",
    "EnumerationDate": "05/23/2024",
    "LastUpdateDate": "02/02/2026",
    "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": "207N00000X",
        "TaxonomyName": "Dermatology Physician",
        "LicenseNumber": "10005170A",
        "LicenseNumberStateCode": "IN",
        "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."
      }
    }
  }
}
                
            

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