{
"Npi": {
"NPI": "1720386428",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "MAGDA",
"FirstName": "ASHLEY",
"MiddleName": "DEBARBA",
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "DEBARBA",
"OtherFirstName": "ASHLEY",
"OtherMiddleName": "ELIZABETH",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "DO",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "1038 N WOLCOTT AVE UNIT 3",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHICAGO",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60622-3759",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "860-301-8066",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "326 W 64TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CHICAGO",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60621-3114",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "773-962-3900",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/03/2011",
"LastUpdateDate": "06/30/2015",
"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": "207P00000X",
"TaxonomyName": "Emergency Medicine Physician",
"LicenseNumber": "036.136393",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "207P00000X",
"TaxonomyName": "Emergency Medicine Physician",
"LicenseNumber": "336.097692",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}