{
"Npi": {
"NPI": "1346423399",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SPS FAMILY CARE, S.C.",
"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": "750 PEARSON ST",
"SecondLineMailingAddress": "507",
"MailingAddressCityName": "DES PLAINES",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60016-9211",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "773-619-0127",
"MailingAddressFaxNumber": "847-635-2002",
"FirstLinePracticeLocationAddress": "1810 W CHICAGO AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CHICAGO",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60622-5512",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "773-489-6100",
"PracticeLocationAddressFaxNumber": "773-489-6156",
"EnumerationDate": "12/13/2007",
"LastUpdateDate": "09/08/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PRIETO",
"AuthorizedOfficialFirstName": "SORVEIN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "FAMILY PRACTICE",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "773-619-0127",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "036118602",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}