{
"Npi": {
"NPI": "1174901326",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "EYEMART INC",
"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": "104 E MAIN ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "STREATOR",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "61364-2901",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "815-672-1161",
"MailingAddressFaxNumber": "815-672-7581",
"FirstLinePracticeLocationAddress": "104 E MAIN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "STREATOR",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "61364-2901",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "815-672-1161",
"PracticeLocationAddressFaxNumber": "815-672-7581",
"EnumerationDate": "05/08/2015",
"LastUpdateDate": "05/08/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ACKERMAN",
"AuthorizedOfficialFirstName": "GAYLE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "815-672-1161",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332H00000X",
"TaxonomyName": "Eyewear Supplier",
"LicenseNumber": "1013061795",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}