{
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"FirstLineMailingAddress": "7124 WINDSOR LAKE PKWY",
"SecondLineMailingAddress": "SUITE # 10",
"MailingAddressCityName": "LOVES PARK",
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"MailingAddressPostalCode": "61111-3800",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "815-633-8688",
"MailingAddressFaxNumber": "815-633-8299",
"FirstLinePracticeLocationAddress": "7124 WINDSOR LAKE PKWY",
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"PracticeLocationAddressCountryCode": "US",
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"PracticeLocationAddressFaxNumber": "815-633-8299",
"EnumerationDate": "04/15/2010",
"LastUpdateDate": "04/15/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BUDZYNSKI",
"AuthorizedOfficialFirstName": "JOHN",
"AuthorizedOfficialMiddleName": "ANDREW",
"AuthorizedOfficialTitle": "OWNER/CEO",
"AuthorizedOfficialNamePrefix": "MR.",
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"AuthorizedOfficialCredential": "L.C.P.C.",
"AuthorizedOfficialTelephoneNumber": "815-633-8688",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "101YP2500X",
"TaxonomyName": "Professional Counselor",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}