{
"Npi": {
"NPI": "1194908657",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DENNIS J WOLNY DPM PC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 142",
"SecondLineMailingAddress": "251 FOUNDERS WAY",
"MailingAddressCityName": "PARK FOREST",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60466-0142",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "708-748-6292",
"MailingAddressFaxNumber": "708-748-6988",
"FirstLinePracticeLocationAddress": "251 FOUNDERS WAY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PARK FOREST",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60466-0142",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "708-748-6292",
"PracticeLocationAddressFaxNumber": "708-748-6988",
"EnumerationDate": "12/07/2007",
"LastUpdateDate": "10/01/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WOLNY",
"AuthorizedOfficialFirstName": "DENNIS",
"AuthorizedOfficialMiddleName": "J",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPM PC",
"AuthorizedOfficialTelephoneNumber": "708-748-6292",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "213E00000X",
"TaxonomyName": "Podiatrist",
"LicenseNumber": "016002426",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}