{
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"FirstLineMailingAddress": "16149 CLINTON ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HARVEY",
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"MailingAddressPostalCode": "60426-5908",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "800-848-2159",
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"FirstLinePracticeLocationAddress": "3900 W 203RD ST",
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"PracticeLocationAddressCityName": "OLYMPIA FIELDS",
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"PracticeLocationAddressTelephoneNumber": "708-679-2000",
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"EnumerationDate": "10/26/2012",
"LastUpdateDate": "11/13/2023",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WESSEL",
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"AuthorizedOfficialTelephoneNumber": "317-705-4530",
"Taxonomies": {
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"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "203.001506",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}