{
"Npi": {
"NPI": "1649634247",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PREMIER FAMILY HEALTH AND WELLNESS CENTER 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": "2340 S HIGHLAND AVE STE 370",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LOMBARD",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60148-5397",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "630-445-1022",
"MailingAddressFaxNumber": "630-559-7377",
"FirstLinePracticeLocationAddress": "2340 S HIGHLAND AVE STE 370",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LOMBARD",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60148-5397",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "630-445-1022",
"PracticeLocationAddressFaxNumber": "630-559-7377",
"EnumerationDate": "04/09/2016",
"LastUpdateDate": "02/25/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CHAKEER",
"AuthorizedOfficialFirstName": "RIDHA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "630-276-3291",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207QB0002X",
"TaxonomyName": "Obesity Medicine (Family Medicine) Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
]
}
}
}