{
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"FirstLineMailingAddress": "PO BOX 471",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HINSDALE",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60522-0471",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "888-960-4562",
"MailingAddressFaxNumber": "630-571-6038",
"FirstLinePracticeLocationAddress": "201 E OGDEN AVE",
"SecondLinePracticeLocationAddress": "SUITE 218",
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"EnumerationDate": "01/09/2013",
"LastUpdateDate": "01/09/2013",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JUCKNIESS",
"AuthorizedOfficialFirstName": "LOUISE",
"AuthorizedOfficialMiddleName": "MARIE",
"AuthorizedOfficialTitle": "MANAGING PARTNER",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "888-960-4562",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Physical Therapist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}