{
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"FirstLineMailingAddress": "126 E WING ST",
"SecondLineMailingAddress": "#185",
"MailingAddressCityName": "ARLINGTON HEIGHTS",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "847-560-4676",
"MailingAddressFaxNumber": "630-689-5809",
"FirstLinePracticeLocationAddress": "1555 BARRINGTON RD",
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"PracticeLocationAddressCityName": "HOFFMAN ESTATES",
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"EnumerationDate": "09/26/2005",
"LastUpdateDate": "08/14/2014",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": "M",
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"Taxonomies": {
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"TaxonomyName": "Surgery Physician",
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"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}