{
"Npi": {
"NPI": "1578752887",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NORTHERN ILLINOIS WOMEN'S CENTER",
"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": "1400 BROADWAY",
"SecondLineMailingAddress": "SUITE 201",
"MailingAddressCityName": "ROCKFORD",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "61104-1400",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "815-963-4101",
"MailingAddressFaxNumber": "815-963-6122",
"FirstLinePracticeLocationAddress": "1400 BROADWAY",
"SecondLinePracticeLocationAddress": "SUITE 201",
"PracticeLocationAddressCityName": "ROCKFORD",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "61104-1400",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "815-963-4101",
"PracticeLocationAddressFaxNumber": "815-963-6122",
"EnumerationDate": "10/23/2007",
"LastUpdateDate": "06/18/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CHRISTENSEN",
"AuthorizedOfficialFirstName": "DENNIS",
"AuthorizedOfficialMiddleName": "D",
"AuthorizedOfficialTitle": "CLINIC DIRECTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "815-963-4101",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QA0005X",
"TaxonomyName": "Ambulatory Family Planning Facility",
"LicenseNumber": "7002967",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}