{
"Npi": {
"NPI": "1841003274",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "XPRESS PHARMACY INC",
"ParentOrgTIN": null,
"OrgName": "XPRESS PHARMACY INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "6700 W 95TH ST STE 150",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "OAK LAWN",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60453-2280",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "708-598-5000",
"MailingAddressFaxNumber": "708-598-6737",
"FirstLinePracticeLocationAddress": "6700 W 95TH ST STE 150",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "OAK LAWN",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60453-2280",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "708-598-5000",
"PracticeLocationAddressFaxNumber": "708-598-6737",
"EnumerationDate": "01/29/2025",
"LastUpdateDate": "02/10/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ALZEIN",
"AuthorizedOfficialFirstName": "DEMA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARMD",
"AuthorizedOfficialTelephoneNumber": "708-598-5000",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336L0003X",
"TaxonomyName": "Long Term Care Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}