{
"Npi": {
"NPI": "1578548608",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NEUROPSYCHOLOGICAL ASSOCIATES, P.C.",
"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": "7300 W COLLEGE DR",
"SecondLineMailingAddress": "SUITE 101",
"MailingAddressCityName": "PALOS HEIGHTS",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60463-1152",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "708-448-8470",
"MailingAddressFaxNumber": "708-448-8470",
"FirstLinePracticeLocationAddress": "16001 S 108TH AVE",
"SecondLinePracticeLocationAddress": "SUITE 2",
"PracticeLocationAddressCityName": "ORLAND PARK",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60467",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "708-403-9000",
"PracticeLocationAddressFaxNumber": "708-403-9988",
"EnumerationDate": "12/13/2005",
"LastUpdateDate": "07/29/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MARKIN",
"AuthorizedOfficialFirstName": "RICHARD",
"AuthorizedOfficialMiddleName": "ALLAN",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHD",
"AuthorizedOfficialTelephoneNumber": "847-702-6499",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "103T00000X",
"TaxonomyName": "Psychologist",
"LicenseNumber": "071 001225",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}