{
"Npi": {
"NPI": "1386918936",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DME ACCESS 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": "1717 INDUSTRIAL DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MONTGOMERY",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60538-1233",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "630-892-7400",
"MailingAddressFaxNumber": "630-892-7401",
"FirstLinePracticeLocationAddress": "9016 58TH PL STE 400",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KENOSHA",
"PracticeLocationAddressStateName": "WI",
"PracticeLocationAddressPostalCode": "53144-7814",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "262-605-1300",
"PracticeLocationAddressFaxNumber": "262-605-1301",
"EnumerationDate": "02/29/2012",
"LastUpdateDate": "02/29/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CREATURA",
"AuthorizedOfficialFirstName": "PAUL",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "630-892-7400",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332BC3200X",
"TaxonomyName": "Customized Equipment (DME)",
"LicenseNumber": "IL 02838",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}