{
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"FirstLineMailingAddress": "2200 W WAR MEMORIAL DR",
"SecondLineMailingAddress": "PEAREL VISION C/O ROBERT QUILLEASH, OD",
"MailingAddressCityName": "PEORIA",
"MailingAddressStateName": "IL",
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"FirstLinePracticeLocationAddress": "2200 W WAR MEMORIAL DR",
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"EnumerationDate": "02/17/2011",
"LastUpdateDate": "08/13/2012",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "QUILLEASH",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": "O.D.",
"AuthorizedOfficialTelephoneNumber": "309-370-3059",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Optometrist",
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"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}