{
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"EIN": null,
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"OrgName": "BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS",
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"FirstLineMailingAddress": "840 S WOOD ST",
"SecondLineMailingAddress": "ROOM 345H MC 884",
"MailingAddressCityName": "CHICAGO",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60612-4325",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "312-355-2035",
"MailingAddressFaxNumber": "312-355-1916",
"FirstLinePracticeLocationAddress": "1801 W TAYLOR ST",
"SecondLinePracticeLocationAddress": "ROOM 309 MC 884",
"PracticeLocationAddressCityName": "CHICAGO",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "312-996-8675",
"PracticeLocationAddressFaxNumber": "312-355-1916",
"EnumerationDate": "02/08/2007",
"LastUpdateDate": "03/07/2023",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VANKUIKEN",
"AuthorizedOfficialFirstName": "KRISTINE",
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"Taxonomies": {
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"TaxonomyName": "Clinic Pharmacy",
"LicenseNumber": "054-017119",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}