NPI Code Detail JSON Logo

1366576670 NPI number — ALLAN CHASE MS, ATC

NPI Number: 1366576670
Health Care Provider/Practitioner: ALLAN CHASE MS, ATC

Information about “1366576670” NPI (ALLAN CHASE MS, ATC) exists in 1366576670 in HTML format HTML  |  1366576670 in plain Text format TXT  |  1366576670 in PDF (Portable Document Format) PDF  |  1366576670 in an XML format XML  formats.

NPI Number : 1366576670 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1366576670",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CHASE",
    "FirstName": "ALLAN",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MS, ATC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1337 JEFFREY DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "RANTOUL",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "61866-1705",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "815-302-9577",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "102 MERCURY DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CHAMPAIGN",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "61822-9650",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "217-363-5205",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/16/2007",
    "LastUpdateDate": "12/19/2018",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2255A2300X",
          "TaxonomyName": "Athletic Trainer",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "SC",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2255A2300X",
          "TaxonomyName": "Athletic Trainer",
          "LicenseNumber": "AL2023",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2255A2300X",
          "TaxonomyName": "Athletic Trainer",
          "LicenseNumber": "AT3267",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2255A2300X",
          "TaxonomyName": "Athletic Trainer",
          "LicenseNumber": "AT001604",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2255A2300X",
          "TaxonomyName": "Athletic Trainer",
          "LicenseNumber": "ATH.200358",
          "LicenseNumberStateCode": "LA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2255A2300X",
          "TaxonomyName": "Athletic Trainer",
          "LicenseNumber": "096002191",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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