{
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"FirstLineMailingAddress": "401 DIVISION ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ROCKFORD",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "61104-2014",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "815-720-4000",
"MailingAddressFaxNumber": "815-720-4001",
"FirstLinePracticeLocationAddress": "401 DIVISION ST",
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"PracticeLocationAddressCityName": "ROCKFORD",
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"PracticeLocationAddressTelephoneNumber": "815-720-4000",
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"EnumerationDate": "02/26/2009",
"LastUpdateDate": "04/17/2009",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BACON",
"AuthorizedOfficialFirstName": "J",
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"AuthorizedOfficialTelephoneNumber": "815-720-4210",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Public Health or Welfare Agency",
"LicenseNumber": "14D0430142",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}