{
"Npi": {
"NPI": "1801556964",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "AFRICAN AMERICAN CHRISTIAN FOUNDATION",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "6707 NORTH AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "OAK PARK",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60302-1006",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "708-848-1700",
"MailingAddressFaxNumber": "708-848-3710",
"FirstLinePracticeLocationAddress": "6707 NORTH AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "OAK PARK",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60302-1006",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "708-848-1700",
"PracticeLocationAddressFaxNumber": "708-848-3710",
"EnumerationDate": "12/29/2021",
"LastUpdateDate": "01/02/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GYABAAH",
"AuthorizedOfficialFirstName": "GLADYS",
"AuthorizedOfficialMiddleName": "GYABAAH",
"AuthorizedOfficialTitle": "PSYCHLOGIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHD",
"AuthorizedOfficialTelephoneNumber": "773-867-0635",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251B00000X",
"TaxonomyName": "Case Management Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251J00000X",
"TaxonomyName": "Nursing Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "253J00000X",
"TaxonomyName": "Foster Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QM1000X",
"TaxonomyName": "Migrant Health Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "286500000X",
"TaxonomyName": "Military Hospital",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "323P00000X",
"TaxonomyName": "Psychiatric Residential Treatment Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "333300000X",
"TaxonomyName": "Emergency Response System Companies",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336M0002X",
"TaxonomyName": "Mail Order Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336S0011X",
"TaxonomyName": "Specialty Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "343800000X",
"TaxonomyName": "Secured Medical Transport (VAN)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251K00000X",
"TaxonomyName": "Public Health or Welfare Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}