{
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"NamePrefix": null,
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"FirstLineMailingAddress": "2300 W MAIN STREET",
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"MailingAddressStateName": "IL",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "314-965-4700",
"MailingAddressFaxNumber": "618-529-7653",
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"EnumerationDate": "01/15/2010",
"LastUpdateDate": "11/08/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SCHREIBER",
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"AuthorizedOfficialTelephoneNumber": "314-965-4700",
"Taxonomies": {
"Taxonomy": [
{
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"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
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}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}