{
"Npi": {
"NPI": "1114119245",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PAUL M. BAUBLY, M.D. S. C.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "103 N HAVEN RD FL 2",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ELMHURST",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60126-2973",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "630-595-9988",
"MailingAddressFaxNumber": "313-225-2296",
"FirstLinePracticeLocationAddress": "103 N HAVEN RD FL 2",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ELMHURST",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60126-2973",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "630-595-9988",
"PracticeLocationAddressFaxNumber": "331-225-2296",
"EnumerationDate": "08/13/2007",
"LastUpdateDate": "09/24/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HORNSTRA",
"AuthorizedOfficialFirstName": "MARGARET",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OFFICE MANAGER",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "630-595-9988",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "036082085",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}