{
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"FirstLineMailingAddress": "2634 W DEVON AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHICAGO",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "773-336-7632",
"MailingAddressFaxNumber": "773-249-1244",
"FirstLinePracticeLocationAddress": "2634 W DEVON AVE",
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"PracticeLocationAddressFaxNumber": "773-249-1244",
"EnumerationDate": "02/04/2020",
"LastUpdateDate": "11/25/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MOHAMMED",
"AuthorizedOfficialFirstName": "MAJEED",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "773-336-7632",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "376J00000X",
"TaxonomyName": "Homemaker",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}