{
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"FirstLineMailingAddress": "4001A W LOOMIS ROAD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GREENFIELD",
"MailingAddressStateName": "WI",
"MailingAddressPostalCode": "53221",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "414-464-1960",
"MailingAddressFaxNumber": "414-464-4383",
"FirstLinePracticeLocationAddress": "505 W SILVER SPRING DRIVE",
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"PracticeLocationAddressCityName": "GLENDALE",
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"PracticeLocationAddressFaxNumber": "414-755-0022",
"EnumerationDate": "02/13/2007",
"LastUpdateDate": "08/22/2020",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SAJDAK",
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"AuthorizedOfficialCredential": "CPED",
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"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}