{
"Npi": {
"NPI": "1619557659",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RAY GRAHAM ASSOCIATION FOR PEOPLE WITH DISABILIT",
"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": "901 WARRENVILLE RD STE 500",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LISLE",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60532-4319",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "630-620-2222",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1108 N MAIN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LOMBARD",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60148-1362",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "630-953-9574",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/13/2021",
"LastUpdateDate": "11/01/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ZOELLER",
"AuthorizedOfficialFirstName": "KIMBERLY",
"AuthorizedOfficialMiddleName": "RAYE",
"AuthorizedOfficialTitle": "PRESIDENT & CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "630-620-2222",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM0850X",
"TaxonomyName": "Adult Mental Health Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}