{
"Npi": {
"NPI": "1548533870",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SKOKIE MEDICAL CENTER LLC",
"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": "3S138 PARK BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GLEN ELLYN",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60137-7233",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "630-605-2646",
"MailingAddressFaxNumber": "630-790-0655",
"FirstLinePracticeLocationAddress": "8301 SKOKIE BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SKOKIE",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60077-2546",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "847-674-4481",
"PracticeLocationAddressFaxNumber": "847-674-4491",
"EnumerationDate": "02/16/2012",
"LastUpdateDate": "03/07/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BASSIRATPOUR",
"AuthorizedOfficialFirstName": "MEHDI",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/MANAGER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "630-605-2646",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "036106820",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}