{
"Npi": {
"NPI": "1477164929",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "LEE",
"FirstName": "MONIQUE",
"MiddleName": "L",
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CONSULTANT",
"OtherFirstName": "ML",
"OtherMiddleName": "NURSE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "LPN, NC",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "8528 S EXCHANGE AVE # 2",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHICAGO",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60617-2541",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "872-777-1455",
"MailingAddressFaxNumber": "312-428-9349",
"FirstLinePracticeLocationAddress": "8528 S EXCHANGE AVE # 2",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CHICAGO",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60617-2541",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "872-777-1455",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/10/2020",
"LastUpdateDate": "08/10/2020",
"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": "164W00000X",
"TaxonomyName": "Licensed Practical Nurse",
"LicenseNumber": "043088275",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}