{
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"FirstLineMailingAddress": "1940 S WESTERN AVENUE",
"SecondLineMailingAddress": "SUITE 205",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "844-285-1003",
"FirstLinePracticeLocationAddress": "4700 S CALIFORNIA AVE",
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"PracticeLocationAddressCityName": "CHICAGO",
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"PracticeLocationAddressTelephoneNumber": "773-584-6200",
"PracticeLocationAddressFaxNumber": "844-285-1003",
"EnumerationDate": "07/12/2017",
"LastUpdateDate": "10/15/2021",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Marriage & Family Therapist",
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"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}