{
"Npi": {
"NPI": "1710096326",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "KAESKE",
"FirstName": "LAURA",
"MiddleName": "LYNN",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "DC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "NIEDER",
"OtherFirstName": "LAURA",
"OtherMiddleName": "KAESKE",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "DC",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "1132 OXFORD RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DEERFIELD",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60015-3325",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "847-607-8561",
"MailingAddressFaxNumber": "847-236-1195",
"FirstLinePracticeLocationAddress": "2101 WAUKEGAN RD STE 100",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BANNOCKBURN",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60015-1836",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "847-236-1194",
"PracticeLocationAddressFaxNumber": "847-236-1195",
"EnumerationDate": "08/29/2006",
"LastUpdateDate": "10/01/2024",
"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": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "038007864",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}