{
"Npi": {
"NPI": "1104165281",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "FRIEDMAN",
"FirstName": "ELIZABETH",
"MiddleName": "MORICK",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "PH.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "240 CLINTON AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "OAK PARK",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60302-3114",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "708-689-0160",
"MailingAddressFaxNumber": "708-689-8158",
"FirstLinePracticeLocationAddress": "7777 LAKE ST",
"SecondLinePracticeLocationAddress": "SUITE 114",
"PracticeLocationAddressCityName": "RIVER FOREST",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60305-1734",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "708-689-0160",
"PracticeLocationAddressFaxNumber": "708-689-8158",
"EnumerationDate": "02/08/2013",
"LastUpdateDate": "02/08/2013",
"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": "103G00000X",
"TaxonomyName": "Clinical Neuropsychologist",
"LicenseNumber": "071-006059",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "103TC0700X",
"TaxonomyName": "Clinical Psychologist",
"LicenseNumber": "071-006059",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}