{
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"FirstLineMailingAddress": "720 OSTERMAN AVE",
"SecondLineMailingAddress": "SUITE 102",
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"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60015-4471",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "847-945-6700",
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"EnumerationDate": "08/03/2010",
"LastUpdateDate": "08/03/2010",
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"GenderCode": null,
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"AuthorizedOfficialLastName": "LOGIUDICE",
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"AuthorizedOfficialTitle": "OWNER, PRESIDENT",
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"AuthorizedOfficialTelephoneNumber": "847-945-6700",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Oral and Maxillofacial Surgery (Dentist)",
"LicenseNumber": "019025769",
"LicenseNumberStateCode": "IL",
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}
},
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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."
}
}
}
}