NPI Code Detail JSON Logo

1912201310 NPI number — NATIONAL CENTER FOR INTEGRATIVE MEDICINE

NPI Number: 1912201310
Health Care Provider/Practitioner: NATIONAL CENTER FOR INTEGRATIVE MEDICINE

Information about “1912201310” NPI (NATIONAL CENTER FOR INTEGRATIVE MEDICINE) exists in 1912201310 in HTML format HTML  |  1912201310 in plain Text format TXT  |  1912201310 in PDF (Portable Document Format) PDF  |  1912201310 in an XML format XML  formats.

NPI Number : 1912201310 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1912201310",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "NATIONAL CENTER FOR INTEGRATIVE MEDICINE",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3100 THEODORE ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "JOLIET",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60435-8534",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "815-330-3100",
    "MailingAddressFaxNumber": "815-330-3115",
    "FirstLinePracticeLocationAddress": "3100 THEODORE ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "JOLIET",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60435-8534",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "815-330-3100",
    "PracticeLocationAddressFaxNumber": "815-330-3115",
    "EnumerationDate": "12/29/2010",
    "LastUpdateDate": "12/29/2010",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "KILARU",
    "AuthorizedOfficialFirstName": "RAO",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PRESIDENT/CEO",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "M.D.",
    "AuthorizedOfficialTelephoneNumber": "815-330-3100",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "111N00000X",
          "TaxonomyName": "Chiropractor",
          "LicenseNumber": "38.011832",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "36.113633",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": "85.003604",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207P00000X",
          "TaxonomyName": "Emergency Medicine Physician",
          "LicenseNumber": "36.060189",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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