1669834701 NPI number — JAMIE GILMARTIN L.C.P.C, C.A.D.C.

NPI Number: 1669834701
Health Care Provider/Practitioner: JAMIE GILMARTIN L.C.P.C, C.A.D.C.

NPI Number : 1669834701 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1669834701",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GILMARTIN",
    "FirstName": "JAMIE",
    "MiddleName": null,
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "L.C.P.C, C.A.D.C.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "6239 W 94TH ST",
    "SecondLineMailingAddress": "APARTMENT 1N",
    "MailingAddressCityName": "OAK LAWN",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60453-2248",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "708-574-3437",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "7300 W COLLEGE DR",
    "SecondLinePracticeLocationAddress": "# 203",
    "PracticeLocationAddressCityName": "PALOS HEIGHTS",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60463-1152",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "708-448-7848",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/28/2016",
    "LastUpdateDate": "03/28/2016",
    "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": "101YA0400X",
          "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
          "LicenseNumber": "29773",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "180.00993",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}