{
"Npi": {
"NPI": "1144404013",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DR. JAMES CHAPKO D.D.S., P.C.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "140 N STATE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BELVIDERE",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "61008-3518",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "815-544-5144",
"MailingAddressFaxNumber": "815-544-5161",
"FirstLinePracticeLocationAddress": "140 N STATE ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BELVIDERE",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "61008-3518",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "815-544-5144",
"PracticeLocationAddressFaxNumber": "815-544-5161",
"EnumerationDate": "12/27/2007",
"LastUpdateDate": "06/18/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CHAPKO",
"AuthorizedOfficialFirstName": "JAMES",
"AuthorizedOfficialMiddleName": "RUDOLPH",
"AuthorizedOfficialTitle": "DENTIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.D.S.",
"AuthorizedOfficialTelephoneNumber": "815-544-5144",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "302F00000X",
"TaxonomyName": "Exclusive Provider Organization",
"LicenseNumber": "019019738",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}