{
"Npi": {
"NPI": "1154576429",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WILSON",
"FirstName": "JODI",
"MiddleName": "G",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "JODI WILSON",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "GIVNER",
"OtherFirstName": "JODI",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "M.A., CCC-SP-LANG",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "5 COURT OF HIDDEN WLS",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NORTHBROOK",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60062-3209",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "847-715-9898",
"MailingAddressFaxNumber": "224-723-5151",
"FirstLinePracticeLocationAddress": "5 COURT OF HIDDEN WLS",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NORTHBROOK",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60062-3209",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "847-715-9898",
"PracticeLocationAddressFaxNumber": "224-723-5151",
"EnumerationDate": "11/29/2008",
"LastUpdateDate": "11/29/2008",
"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": "235Z00000X",
"TaxonomyName": "Speech-Language Pathologist",
"LicenseNumber": "146.009615",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}