{
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"FirstLineMailingAddress": "710 VICTORIA LN",
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"MailingAddressStateName": "IL",
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"MailingAddressFaxNumber": "618-256-4303",
"FirstLinePracticeLocationAddress": "310 W LOSEY ST",
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"PracticeLocationAddressCityName": "SCOTT AFB",
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"PracticeLocationAddressTelephoneNumber": "618-256-4741",
"PracticeLocationAddressFaxNumber": "618-256-4303",
"EnumerationDate": "07/25/2006",
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"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}