{
"Npi": {
"NPI": "1871929703",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "LEVANDER",
"FirstName": "JOHN",
"MiddleName": "ANDREW",
"NamePrefix": "MR.",
"NameSuffix": "III",
"Credential": "P.T.A.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1484 S PEMBROKE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SOUTH ELGIN",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60177-2931",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "331-425-5072",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "22320 CLASSIC CT",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LAKE BARRINGTON",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60010-5903",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "847-382-1568",
"PracticeLocationAddressFaxNumber": "847-382-1585",
"EnumerationDate": "09/24/2013",
"LastUpdateDate": "09/24/2013",
"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": "225200000X",
"TaxonomyName": "Physical Therapy Assistant",
"LicenseNumber": "160.006528",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}