1255491353 NPI number — LILLI A SHEMBOR BISHOP M.A., C.C.C.

NPI Number: 1255491353
Health Care Provider/Practitioner: LILLI A SHEMBOR BISHOP M.A., C.C.C.

NPI Number : 1255491353 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1255491353",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SHEMBOR BISHOP",
    "FirstName": "LILLI",
    "MiddleName": "A",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.A., C.C.C.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SHEMBOR",
    "OtherFirstName": "LILLI",
    "OtherMiddleName": "A",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "M.A., C.C.C.",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "134 BUENA VISTA DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DEKALB",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60115-1013",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "815-753-6521",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1LUCINDA AVENUE",
    "SecondLinePracticeLocationAddress": "NORTHERN ILLINOIS UNIV., SPEECH-LANGUAGE-HEARING CLINIC",
    "PracticeLocationAddressCityName": "DEKALB",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60115-2899",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "815-753-6521",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/11/2006",
    "LastUpdateDate": "06/21/2012",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "235Z00000X",
        "TaxonomyName": "Speech-Language Pathologist",
        "LicenseNumber": "146002905",
        "LicenseNumberStateCode": "IL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}