{
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"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "4210 W. IRVING PARK ROAD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHICAGO",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60641",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "312-493-7744",
"MailingAddressFaxNumber": "773-777-7055",
"FirstLinePracticeLocationAddress": "4210 W. IRVING PARK ROAD",
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"PracticeLocationAddressCityName": "CHICAGO",
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"PracticeLocationAddressFaxNumber": "773-777-7055",
"EnumerationDate": "06/28/2011",
"LastUpdateDate": "06/28/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PIOTROWSKA",
"AuthorizedOfficialFirstName": "DOMINIKA",
"AuthorizedOfficialMiddleName": "ANDZELICA",
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"AuthorizedOfficialCredential": "D.N.",
"AuthorizedOfficialTelephoneNumber": "312-493-7744",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "172P00000X",
"TaxonomyName": "Naprapath",
"LicenseNumber": "181.000366",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}