{
"Npi": {
"NPI": "1477836625",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "FAKHOURI",
"FirstName": "JUDY",
"MiddleName": "MEEKYUNG",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "PHARMD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "LEE",
"OtherFirstName": "JUDY",
"OtherMiddleName": "MEEKYUNG",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "PHARMD",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "918 W CAROLYN DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PALATINE",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60067",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "847-502-0876",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "108 WILMOT RD # MS 1822",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DEERFIELD",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60015-5145",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "847-580-0000",
"PracticeLocationAddressFaxNumber": "847-315-3905",
"EnumerationDate": "09/23/2011",
"LastUpdateDate": "01/24/2022",
"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": "051290634",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}