{
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"FirstLineMailingAddress": "1904 174TH ST",
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"FirstLinePracticeLocationAddress": "17223 THROOP ST",
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"PracticeLocationAddressCityName": "EAST HAZEL CREST",
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"EnumerationDate": "08/07/2025",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BROWN",
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"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}