{
"Npi": {
"NPI": "1083020143",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NORTH SHORE HEALTHCARE, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"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": "9944 S ROBERTS RD",
"SecondLineMailingAddress": "SUITE 210",
"MailingAddressCityName": "PALOS HILLS",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60465-1555",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "708-658-6545",
"MailingAddressFaxNumber": "708-658-6715",
"FirstLinePracticeLocationAddress": "8755 TRUMBULL AVE",
"SecondLinePracticeLocationAddress": "SECOND 2ND FLOOR",
"PracticeLocationAddressCityName": "SKOKIE",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60076",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "847-213-0483",
"PracticeLocationAddressFaxNumber": "847-213-0501",
"EnumerationDate": "07/09/2014",
"LastUpdateDate": "04/16/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "AKHTER",
"AuthorizedOfficialFirstName": "REHAN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "773-886-0473",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "041-211658",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}