{
"Npi": {
"NPI": "1477719375",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CAMBIC",
"FirstName": "ANGELA",
"MiddleName": "LUBKE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "LUBKE",
"OtherFirstName": "ANGELA",
"OtherMiddleName": "MARIE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "4250 N MARINE DR",
"SecondLineMailingAddress": "1616",
"MailingAddressCityName": "CHICAGO",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60613-1744",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "312-560-9981",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "25 N WINFIELD RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WINFIELD",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60190-1379",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "630-933-6675",
"PracticeLocationAddressFaxNumber": "630-933-2614",
"EnumerationDate": "07/31/2008",
"LastUpdateDate": "07/03/2024",
"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": "207L00000X",
"TaxonomyName": "Anesthesiology Physician",
"LicenseNumber": "125-052837",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207LP3000X",
"TaxonomyName": "Pediatric Anesthesiology Physician",
"LicenseNumber": "036128165",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}