{
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"IsOrgSubpart": "N",
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"OrgName": "PEAK PHYSICAL THERAPY CLINIC LLC",
"LastName": null,
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"FirstLineMailingAddress": "1111 N PLAZA DR",
"SecondLineMailingAddress": "SUITE 706",
"MailingAddressCityName": "SCHAUMBURG",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60173-6021",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "847-393-4501",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "455 E GRAND RIVER AVE",
"SecondLinePracticeLocationAddress": "SUITE 102",
"PracticeLocationAddressCityName": "BRIGHTON",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48116-1551",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "810-360-0806",
"PracticeLocationAddressFaxNumber": "844-809-2246",
"EnumerationDate": "02/22/2016",
"LastUpdateDate": "05/04/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "IGYARTO",
"AuthorizedOfficialFirstName": "CHRISTINE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DIRECTOR OF REVENUE",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "847-393-4691",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
}
}
}