{
"Npi": {
"NPI": "1336800630",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PRECISE HEALTHCARE SOLUTIONS LLC",
"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": "3200 BROOKSIDE BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "OLYMPIA FIELDS",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60461-1863",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "708-833-9014",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3235 VOLLMER RD STE 104",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FLOSSMOOR",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60422-2069",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "708-631-3917",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/07/2022",
"LastUpdateDate": "01/18/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HUGHES",
"AuthorizedOfficialFirstName": "KRISTI",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DNP, FNP-BC",
"AuthorizedOfficialTelephoneNumber": "708-833-9014",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "291U00000X",
"TaxonomyName": "Clinical Medical Laboratory",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QH0100X",
"TaxonomyName": "Health Service Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}