{"npi":"1710375043","type":"NPI-1","status":"active","name":{"display":"Teresa Fortenberry Nurse Practitioner","other":[],"first":"TERESA","last":"FORTENBERRY","credential":"NURSE PRACTITIONER"},"specialty":{"primary_taxonomy":"363L00000X","primary_taxonomy_description":"Nurse Practitioner","slug":"nurse-practitioner","schema_org_specialty":null,"all":[{"code":"363L00000X","description":"Nurse Practitioner","primary":true,"state":"IL","license":"209-011536"}]},"addresses":[{"purpose":"LOCATION","street_1":"2160 S 1ST AVE","city":"MAYWOOD","state":"IL","postal_code":"601533328","country_code":"US","phone":"7082169000"},{"purpose":"MAILING","street_1":"2160 S 1ST AVE","city":"MAYWOOD","state":"IL","postal_code":"601533328","country_code":"US"}],"license":{"state":"IL","number":"209-011536"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20150302001185","type_code":"14-50","type_desc":"PRACTITIONER - NURSE PRACTITIONER","state":"IL","pac_id":"3971829359"}]},"enumeration_date":"2015-01-09","last_updated":"2022-01-27","_meta":{"source":"NPPES","snapshot_date":"2022-01-27","doc_url":"https://findmynpi.com/api"}}