{
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  "enumeration_type": "NPI-1",
  "basic": {
    "certification_date": "2026-10-29",
    "enumeration_date": "2007-04-02",
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      "telephone_number": "847-390-5900"
    },
    {
      "address_1": "112 WASHINGTON ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "CENTRAL FALLS",
      "country_code": "US",
      "country_name": "United States",
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      "excluded": false,
      "status": "CLEAR",
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      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
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  "enrichment": {
    "plain_english_specialty": "Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
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