{
"Npi": {
"NPI": "1831552876",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "PARKER",
"FirstName": "C. WOODWORTH",
"MiddleName": null,
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "D.O.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "PARKER",
"OtherFirstName": "CHRISTOPHER",
"OtherMiddleName": "WOODWORTH",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "DO",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "5833 N SHERIDAN RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHICAGO",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60660-3835",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "816-304-1599",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "5645 W ADDISON ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CHICAGO",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60634-2881",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "773-794-7601",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/29/2016",
"LastUpdateDate": "11/18/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207P00000X",
"TaxonomyName": "Emergency Medicine Physician",
"LicenseNumber": "036.172111",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}