{"npi":"1619954583","type":"NPI-1","status":"active","name":{"display":"Kenneth Micetich MD","other":[],"first":"KENNETH","last":"MICETICH","middle":"CRAIG","credential":"MD"},"specialty":{"primary_taxonomy":"207RH0003X","primary_taxonomy_description":"Hematology & Oncology","slug":"hematology-oncology","schema_org_specialty":"Oncologic","all":[{"code":"207RH0003X","description":"Hematology & Oncology","primary":true,"state":"IL","license":"36056032"}]},"addresses":[{"purpose":"LOCATION","street_1":"2160 S 1ST AVE","city":"MAYWOOD","state":"IL","postal_code":"601533328","country_code":"US","street_2":"(15750 MARION DR., HOMER GLEN, IL. 60491)","phone":"7086453400","fax":"7086453411"},{"purpose":"MAILING","street_1":"2160 S 1ST AVE","city":"MAYWOOD","state":"IL","postal_code":"601533328","country_code":"US","street_2":"(15750 MARION DR., HOMER GLEN, IL. 60491)","phone":"7086453400","fax":"7086453411"}],"license":{"state":"IL","number":"36056032"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"36056032","state":"IL","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20050822001204","type_code":"14-83","type_desc":"PRACTITIONER - HEMATOLOGY/ONCOLOGY","state":"IL","pac_id":"0244261089"}]},"enumeration_date":"2005-12-30","last_updated":"2010-01-06","_meta":{"source":"NPPES","snapshot_date":"2010-01-06","doc_url":"https://findmynpi.com/api"}}