{
"Npi": {
"NPI": "1326453713",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GARRETT",
"FirstName": "MICHELLE",
"MiddleName": "CARLY",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "APN-CNP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2650 RIDGE AVE # 1223",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "EVANSTON",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60201-1700",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "847-982-3175",
"MailingAddressFaxNumber": "847-982-3394",
"FirstLinePracticeLocationAddress": "757 PARK AVE W STE 2850",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HIGHLAND PARK",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60035-2558",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "847-657-1900",
"PracticeLocationAddressFaxNumber": "847-733-5041",
"EnumerationDate": "06/25/2014",
"LastUpdateDate": "10/13/2025",
"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": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "209011471",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}