{
"Npi": {
"NPI": "1528534344",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SHAH",
"FirstName": "RADHIKA",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MANIAR",
"OtherFirstName": "RADHIKA",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "196 HOLMES WAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SCHAUMBURG",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60193-5738",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "646-671-0418",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "300 S MCLEAN BLVD STE M",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ELGIN",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60123-1023",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "224-535-8515",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/19/2018",
"LastUpdateDate": "08/10/2022",
"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": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": "019.031707",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}