{
  "npi": "1336187749",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "JOHN",
    "authorized_official_last_name": "FITZHORN",
    "authorized_official_name_prefix": "--",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "8153955892",
    "authorized_official_title_or_position": "Director of Patient Accounts",
    "enumeration_date": "2006-06-04",
    "last_updated": "2007-09-10",
    "organization_name": "BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "1601 PARKVIEW AVE",
      "address_2": "S300",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "ROCKFORD",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "815-395-5644",
      "postal_code": "611071822",
      "state": "IL",
      "telephone_number": "815-395-5892"
    },
    {
      "address_1": "2170 PEARL ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "BELVIDERE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "815-544-9681",
      "postal_code": "610086020",
      "state": "IL",
      "telephone_number": "815-547-5461"
    }
  ],
  "taxonomies": [
    {
      "code": "207Q00000X",
      "desc": "Family Medicine",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty 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": "Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor)",
    "certifying_board": "American Board of Family Medicine (ABFM)",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "08",
        "medicare_type": "Physician/Family Practice"
      }
    ]
  }
}