{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "RANDALL F. SUMMERS, D.D.S.,LTD",
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"NamePrefix": null,
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"FirstLineMailingAddress": "391 QUADRANGLE DR",
"SecondLineMailingAddress": "SUITE S-5",
"MailingAddressCityName": "BOLINGBROOK",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60440-3442",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "630-759-4400",
"MailingAddressFaxNumber": "630-759-9528",
"FirstLinePracticeLocationAddress": "391 QUADRANGLE DR",
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"PracticeLocationAddressCityName": "BOLINGBROOK",
"PracticeLocationAddressStateName": "IL",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "630-759-4400",
"PracticeLocationAddressFaxNumber": "630-759-9528",
"EnumerationDate": "03/27/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SUMMERS",
"AuthorizedOfficialFirstName": "RANDALL",
"AuthorizedOfficialMiddleName": "FRANK",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.D.S.",
"AuthorizedOfficialTelephoneNumber": "630-759-4400",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "122300000X",
"TaxonomyName": "Dentist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}