{
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"OrgName": "DELAVAN AMBULANCE SERVICE INC",
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"FirstLineMailingAddress": "PO BOX 747",
"SecondLineMailingAddress": "510 S PINE STREET",
"MailingAddressCityName": "DELAVAN",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "61734-0747",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "309-244-7420",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "510 S PINE STREET",
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"PracticeLocationAddressCityName": "DELAVAN",
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"PracticeLocationAddressTelephoneNumber": "309-244-7420",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/15/2007",
"LastUpdateDate": "05/04/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SPRINGER",
"AuthorizedOfficialFirstName": "CINDY",
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"AuthorizedOfficialTelephoneNumber": "309-244-7420",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Land Ambulance",
"LicenseNumber": "22532",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}