{
"Npi": {
"NPI": "1952919367",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CHUNG",
"FirstName": "GRACE",
"MiddleName": "S",
"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": "2100 N MAYFAIR RD UNIT 203",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WAUWATOSA",
"MailingAddressStateName": "WI",
"MailingAddressPostalCode": "53226-2228",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "608-770-8269",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2275 N MAYFAIR RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WAUWATOSA",
"PracticeLocationAddressStateName": "WI",
"PracticeLocationAddressPostalCode": "53226-2207",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "414-774-4821",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/21/2020",
"LastUpdateDate": "07/21/2020",
"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": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "20343",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}