{
"Npi": {
"NPI": "1124361480",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "THE BROWN CLINIC P.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": "4460 N ILLINOIS ST STE 7",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SWANSEA",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "62226-1899",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "618-222-7277",
"MailingAddressFaxNumber": "618-222-7305",
"FirstLinePracticeLocationAddress": "4460 N ILLINOIS ST STE 7",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SWANSEA",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "62226-1899",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "618-222-7277",
"PracticeLocationAddressFaxNumber": "618-222-7305",
"EnumerationDate": "04/04/2013",
"LastUpdateDate": "12/22/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BROWN",
"AuthorizedOfficialFirstName": "ASHLEY",
"AuthorizedOfficialMiddleName": "RENEE",
"AuthorizedOfficialTitle": "LICENSED CLINICAL SOCIAL WORKER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MSW LCSW",
"AuthorizedOfficialTelephoneNumber": "16182227277",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "305R00000X",
"TaxonomyName": "Preferred Provider Organization",
"LicenseNumber": "149014435",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}