{
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"OrgName": "AURORA L CICEOVAN DDS,PC",
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"FirstLineMailingAddress": "803 KENNICOTT PL",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MOUNT PROSPECT",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60056-4072",
"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "1530 E DUNDEE RD",
"SecondLinePracticeLocationAddress": "SUITE 300",
"PracticeLocationAddressCityName": "PALATINE",
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"EnumerationDate": "03/24/2014",
"LastUpdateDate": "03/24/2014",
"NPIDeactivationReasonCode": null,
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"AuthorizedOfficialLastName": "CICEOVAN",
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"AuthorizedOfficialCredential": "DDS",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "General Practice Dentistry",
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"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}