{
  "npi": "1124021266",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "JOHN",
    "authorized_official_last_name": "SLYKAS",
    "authorized_official_name_prefix": "Mr.",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "7087474000",
    "authorized_official_title_or_position": "Manager",
    "enumeration_date": "2005-05-23",
    "last_updated": "2011-01-10",
    "organization_name": "ALVERNO LAKESIDE CORPORATION",
    "organizational_subpart": "YES",
    "parent_organization_legal_business_name": "ST. JAMES HOSPITAL, UNITED STATES CATHOLIC CONFERENCE",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "20201 CRAWFORD AVE",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "OLYMPIA FIELDS",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "708-755-3392",
      "postal_code": "604611010",
      "state": "IL",
      "telephone_number": "708-747-4000"
    },
    {
      "address_1": "20201 CRAWFORD AVE",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "OLYMPIA FIELDS",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "708-481-5583",
      "postal_code": "604611010",
      "state": "IL",
      "telephone_number": "708-756-1200"
    }
  ],
  "taxonomies": [
    {
      "code": "341600000X",
      "desc": "Ambulance",
      "license": "77967",
      "primary": true,
      "state": "IL",
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance",
    "certifying_board": "State EMS Authority / National Registry of Emergency Medical Technicians (NREMT)",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "59",
        "medicare_type": "Ambulance Service Provider"
      }
    ]
  }
}