{
"Npi": {
"NPI": "1851726301",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CIRIO THERAPY",
"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": "175 N FRANKLIN ST",
"SecondLineMailingAddress": "SUITE 301",
"MailingAddressCityName": "CHICAGO",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60606-1832",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "312-451-8980",
"MailingAddressFaxNumber": "312-602-1002",
"FirstLinePracticeLocationAddress": "1740 RIDGE AVE",
"SecondLinePracticeLocationAddress": "SUITE 200 C",
"PracticeLocationAddressCityName": "EVANSTON",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60201-5918",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "312-451-8980",
"PracticeLocationAddressFaxNumber": "312-602-1002",
"EnumerationDate": "09/03/2013",
"LastUpdateDate": "09/03/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CIRIO",
"AuthorizedOfficialFirstName": "SIMONA",
"AuthorizedOfficialMiddleName": "L",
"AuthorizedOfficialTitle": "SOLE MEMBER",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LMFT",
"AuthorizedOfficialTelephoneNumber": "312-451-8980",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "106H00000X",
"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "166-000786",
"LicenseNumberStateCode": "IL",
"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."
}
}
}
}