{
"Npi": {
"NPI": "1225192073",
"EntityType": "Organization",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "COOK COUNTY HOSPITAL DISTRICT",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "515 5TH AVE W",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GRAND MARAIS",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55604-3017",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "218-387-3040",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "515 5TH AVE W",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GRAND MARAIS",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55604-3017",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "218-387-3040",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/19/2006",
"LastUpdateDate": "11/01/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WRAALSTAD",
"AuthorizedOfficialFirstName": "KIMBER",
"AuthorizedOfficialMiddleName": "L",
"AuthorizedOfficialTitle": "CEO/ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "218-387-3260",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": "331910",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}