{
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"NamePrefix": null,
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"FirstLineMailingAddress": "3331 WHITE EAGLE DR",
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"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60564-4605",
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"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "475 N FARNSWORTH AVE",
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"PracticeLocationAddressCityName": "AURORA",
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"PracticeLocationAddressTelephoneNumber": "630-898-0022",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/02/2011",
"LastUpdateDate": "08/23/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MOHAAN",
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"AuthorizedOfficialTitle": "BILLING MANAGER",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "630-375-6500",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}