{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MCS GLOBAL MEDICAL SUPPLY INC",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1900 N AUSTIN AVE",
"SecondLineMailingAddress": "SUITE 100",
"MailingAddressCityName": "CHICAGO",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60639-5010",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "773-664-0034",
"MailingAddressFaxNumber": "773-664-0035",
"FirstLinePracticeLocationAddress": "1900 N AUSTIN AVE",
"SecondLinePracticeLocationAddress": "SUITE 100",
"PracticeLocationAddressCityName": "CHICAGO",
"PracticeLocationAddressStateName": "IL",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "773-664-0034",
"PracticeLocationAddressFaxNumber": "773-664-0035",
"EnumerationDate": "01/10/2007",
"LastUpdateDate": "09/16/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NWACHUKWU",
"AuthorizedOfficialFirstName": "SAM",
"AuthorizedOfficialMiddleName": "I",
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"AuthorizedOfficialNamePrefix": "MR.",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "773-664-0034",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "203.000451",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}