{
"Npi": {
"NPI": "1275688434",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "VINCENT A. SACKETT, M.D., LTD.",
"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": "201 E OGDEN AVE",
"SecondLineMailingAddress": "SUITE 214",
"MailingAddressCityName": "HINSDALE",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60521-3633",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "630-323-2229",
"MailingAddressFaxNumber": "630-323-5011",
"FirstLinePracticeLocationAddress": "201 E OGDEN AVE",
"SecondLinePracticeLocationAddress": "SUITE 214",
"PracticeLocationAddressCityName": "HINSDALE",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60521-3633",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "630-323-2229",
"PracticeLocationAddressFaxNumber": "630-323-5011",
"EnumerationDate": "01/25/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SACKETT",
"AuthorizedOfficialFirstName": "VINCENT",
"AuthorizedOfficialMiddleName": "ANTHONY",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "630-323-2229",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "2084P0800X",
"TaxonomyName": "Psychiatry Physician",
"LicenseNumber": null,
"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."
}
}
}
}