{
"Npi": {
"NPI": "1942980032",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BECERRA ALWAZAN",
"FirstName": "TIFFANI",
"MiddleName": null,
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "ND, LAC.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "7205 NW GEORGIA AVE",
"SecondLineMailingAddress": "UNIT A",
"MailingAddressCityName": "WASHINGTON",
"MailingAddressStateName": "DC",
"MailingAddressPostalCode": "20012",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "630-447-9847",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "929 S MAIN ST STE 101",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LOMBARD",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60148-3325",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "630-447-9857",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/24/2023",
"LastUpdateDate": "01/07/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "038.014409",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "171100000X",
"TaxonomyName": "Acupuncturist",
"LicenseNumber": "198.001625",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "175F00000X",
"TaxonomyName": "Naturopath",
"LicenseNumber": "2200120",
"LicenseNumberStateCode": "DC",
"PrimaryTaxonomySwitch": "N"
}
]
},
"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."
}
}
}
}