{
"Npi": {
"NPI": "1760860829",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "KLEIN",
"FirstName": "ERICA",
"MiddleName": "LOPATA",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "225 E CHICAGO AVE # 9",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHICAGO",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60611-2991",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "312-227-3484",
"MailingAddressFaxNumber": "312-227-9783",
"FirstLinePracticeLocationAddress": "1775 W DEMPSTER ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PARK RIDGE",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60068-1143",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "847-723-8236",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/09/2015",
"LastUpdateDate": "12/11/2023",
"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": "2085R0202X",
"TaxonomyName": "Diagnostic Radiology Physician",
"LicenseNumber": "125.067700",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2085R0202X",
"TaxonomyName": "Diagnostic Radiology Physician",
"LicenseNumber": "036151606",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "390200000X",
"TaxonomyName": "Student in an Organized Health Care Education/Training Program",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2085P0229X",
"TaxonomyName": "Pediatric Radiology Physician",
"LicenseNumber": "036-151606",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}