{
"Npi": {
"NPI": "1194002774",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WALGREEN CO./ILL.",
"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": "200 WILMOT RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DEERFIELD",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60015-4620",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "801-982-1912",
"MailingAddressFaxNumber": "801-982-1932",
"FirstLinePracticeLocationAddress": "4040 W 5415 S",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SALT LAKE CITY",
"PracticeLocationAddressStateName": "UT",
"PracticeLocationAddressPostalCode": "84118-4308",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "801-982-1912",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/09/2011",
"LastUpdateDate": "11/09/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JOLLEY",
"AuthorizedOfficialFirstName": "CHAD",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PHARMACIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARM D",
"AuthorizedOfficialTelephoneNumber": "801-982-1912",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "9691412-1701",
"LicenseNumberStateCode": "UT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}