{
"Npi": {
"NPI": "1538335740",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "TRIUMPH RADIOLOGY INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1802 DIVISON ST",
"SecondLineMailingAddress": "SUITE 605",
"MailingAddressCityName": "MORRIS",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60450-3133",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "815-741-4148",
"MailingAddressFaxNumber": "815-741-4686",
"FirstLinePracticeLocationAddress": "2121 ONEIDA ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "JOLIET",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60435-6544",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "815-741-4148",
"PracticeLocationAddressFaxNumber": "815-741-4686",
"EnumerationDate": "05/07/2008",
"LastUpdateDate": "05/07/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CHELLAPPA",
"AuthorizedOfficialFirstName": "PAUL",
"AuthorizedOfficialMiddleName": "S",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "815-741-4148",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QR0200X",
"TaxonomyName": "Radiology Clinic/Center",
"LicenseNumber": "244359",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}