{
"Npi": {
"NPI": "1679859029",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DUPAGE PROSTHETIC-ORTHOTIC SERVICE 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": "121 E ROOSEVELT RD",
"SecondLineMailingAddress": "SUITE B & C",
"MailingAddressCityName": "LOMBARD",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60148-4561",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "630-261-9317",
"MailingAddressFaxNumber": "630-261-9319",
"FirstLinePracticeLocationAddress": "1100 SHERMAN AVE",
"SecondLinePracticeLocationAddress": "SUITE 108",
"PracticeLocationAddressCityName": "NAPERVILLE",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60563-8608",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "630-261-9317",
"PracticeLocationAddressFaxNumber": "630-261-9319",
"EnumerationDate": "10/31/2011",
"LastUpdateDate": "10/31/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ROONEY",
"AuthorizedOfficialFirstName": "JOHN",
"AuthorizedOfficialMiddleName": "EDWARD",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "C.P, LO, LCED",
"AuthorizedOfficialTelephoneNumber": "630-261-9317",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "335E00000X",
"TaxonomyName": "Prosthetic/Orthotic Supplier",
"LicenseNumber": "213.000230",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}