{
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"FirstLineMailingAddress": "4555 W SCHROEDER DR",
"SecondLineMailingAddress": "SUITE 170",
"MailingAddressCityName": "MILWAUKEE",
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"MailingAddressPostalCode": "53223-1475",
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"MailingAddressTelephoneNumber": "414-365-3210",
"MailingAddressFaxNumber": "414-365-3225",
"FirstLinePracticeLocationAddress": "575 W RIVER WOODS PKWY",
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"PracticeLocationAddressFaxNumber": "414-961-6727",
"EnumerationDate": "03/26/2007",
"LastUpdateDate": "03/25/2008",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SIMANONOK",
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"AuthorizedOfficialCredential": "MD",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Anesthesiology Physician",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}