{
"Npi": {
"NPI": "1154589463",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WHEATON FRANCISCAN HEALTHCARE",
"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": "3711 S 104TH ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GREENFIELD",
"MailingAddressStateName": "WI",
"MailingAddressPostalCode": "53228-1303",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "414-541-0712",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2025 W OKLAHOMA AVE",
"SecondLinePracticeLocationAddress": "SUITE 104",
"PracticeLocationAddressCityName": "MILWAUKEE",
"PracticeLocationAddressStateName": "WI",
"PracticeLocationAddressPostalCode": "53215-4455",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "414-647-7678",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/23/2008",
"LastUpdateDate": "05/23/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PASSINAULT",
"AuthorizedOfficialFirstName": "DAVID",
"AuthorizedOfficialMiddleName": "ANDREW",
"AuthorizedOfficialTitle": "PHYSICAL THERAPIST",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "P.T.",
"AuthorizedOfficialTelephoneNumber": "414-647-7678",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "3136",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}