{
"Npi": {
"NPI": "1447445739",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "PETER",
"FirstName": "CAROLINE",
"MiddleName": "JUNE",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "R.PH.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "EDWARDS",
"OtherFirstName": "CAROLINE",
"OtherMiddleName": "PETER",
"OtherNamePrefix": "MS.",
"OtherNameSuffix": null,
"OtherCredential": "R.PH.",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "8430 W BRYN MAWR AVE STE 1150",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHICAGO",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60631-3473",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "847-588-7170",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "204 LIBERTY PLAZA",
"SecondLinePracticeLocationAddress": "WEST SWANNANOA AVENUE",
"PracticeLocationAddressCityName": "LIBERTY",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "27298",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "336-622-1444",
"PracticeLocationAddressFaxNumber": "336-622-7299",
"EnumerationDate": "09/10/2007",
"LastUpdateDate": "06/08/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "13557",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}