{
"Npi": {
"NPI": "1184600207",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "X",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "ODONNELL",
"FirstName": "RICHARD",
"MiddleName": "E",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "DO",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "18141 DIXIE HIGHWAY",
"SecondLineMailingAddress": "SUITE 107",
"MailingAddressCityName": "HOMEWOOD",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60430",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "708-799-8440",
"MailingAddressFaxNumber": "708-799-8446",
"FirstLinePracticeLocationAddress": "3927 W 95TH STREET",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "EVERGREEN PARK",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60805",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "708-952-4566",
"PracticeLocationAddressFaxNumber": "708-952-4568",
"EnumerationDate": "12/20/2005",
"LastUpdateDate": "07/08/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}