{
"Npi": {
"NPI": "1639597560",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SAS",
"FirstName": "KATHRYN",
"MiddleName": "E",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "APN",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MICHNIOWSKI",
"OtherFirstName": "KATHRYN",
"OtherMiddleName": "E",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "RN",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "4201 WINFIELD RD",
"SecondLineMailingAddress": "CENTRALIZED SERVICES",
"MailingAddressCityName": "WARRENVILLE",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60555-4025",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "331-221-6377",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "130 S MAIN ST STE 201",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LOMBARD",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60148-2670",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "331-221-9001",
"PracticeLocationAddressFaxNumber": "331-221-3957",
"EnumerationDate": "03/28/2014",
"LastUpdateDate": "06/09/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "163W00000X",
"TaxonomyName": "Registered Nurse",
"LicenseNumber": "041398502",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "209013685",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}