{
"Npi": {
"NPI": "1760706295",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "INFINITY HEALTHCARE STAFFING, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "507 S LA GRANGE RD",
"SecondLineMailingAddress": "2N",
"MailingAddressCityName": "LA GRANGE",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60525-6740",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "708-482-0130",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "507 S LA GRANGE RD",
"SecondLinePracticeLocationAddress": "2N",
"PracticeLocationAddressCityName": "LA GRANGE",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60525-6740",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "708-482-0130",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/26/2010",
"LastUpdateDate": "03/26/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BROKOPP",
"AuthorizedOfficialFirstName": "GEORGETTE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "708-482-0130",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "1967763",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}