NPI Code Detail JSON Logo

1578255675 NPI number — SOLSTICE IMAGING INC

NPI Number: 1578255675
Health Care Provider/Practitioner: SOLSTICE IMAGING INC

Information about “1578255675” NPI (SOLSTICE IMAGING INC) exists in 1578255675 in HTML format HTML  |  1578255675 in plain Text format TXT  |  1578255675 in PDF (Portable Document Format) PDF  |  1578255675 in an XML format XML  formats.

NPI Number : 1578255675 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1578255675",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "SOLSTICE IMAGING INC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "915 N YORK ST APT 603",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ELMHURST",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60126-1256",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "312-520-8824",
    "MailingAddressFaxNumber": "630-501-0012",
    "FirstLinePracticeLocationAddress": "651 N YORK ST # A",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ELMHURST",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60126-1604",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "630-530-0112",
    "PracticeLocationAddressFaxNumber": "312-501-0012",
    "EnumerationDate": "05/25/2023",
    "LastUpdateDate": "03/14/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BALLENTINE",
    "AuthorizedOfficialFirstName": "SUNSHINE",
    "AuthorizedOfficialMiddleName": "JONES",
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MA, LPC",
    "AuthorizedOfficialTelephoneNumber": "312-520-8824",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "335E00000X",
          "TaxonomyName": "Prosthetic/Orthotic Supplier",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "332B00000X",
          "TaxonomyName": "Durable Medical Equipment & Medical Supplies",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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