{
"Npi": {
"NPI": "1336484021",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GLORIA PHARMACY, INC.",
"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": "1141 KASTING LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MUNDELEIN",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60060-9147",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "773-807-5271",
"MailingAddressFaxNumber": "847-566-6878",
"FirstLinePracticeLocationAddress": "8336 W LAWRENCE AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NORRIDGE",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60706-3152",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "773-807-5271",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/06/2012",
"LastUpdateDate": "12/06/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "STOYANOVA",
"AuthorizedOfficialFirstName": "KRASIMIRA",
"AuthorizedOfficialMiddleName": "Z",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "773-807-5271",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}