{"npi":"1720165103","type":"NPI-1","status":"active","name":{"display":"Mrs. Bonnie Coburn NP","other":[],"first":"BONNIE","last":"COBURN","middle":"JEAN","credential":"NP"},"specialty":{"primary_taxonomy":"363LF0000X","primary_taxonomy_description":"Family Nurse Practitioner","slug":"family-nurse-practitioner","schema_org_specialty":null,"all":[{"code":"363LF0000X","description":"Family Nurse Practitioner","primary":true,"state":"IL","license":"277000529"},{"code":"363L00000X","description":"Nurse Practitioner","primary":false,"state":"IL","license":"209006142"}]},"addresses":[{"purpose":"LOCATION","street_1":"4455 E US ROUTE 36","city":"DECATUR","state":"IL","postal_code":"625215003","country_code":"US","phone":"2175882600"},{"purpose":"MAILING","street_1":"4965 E LOST BRIDGE RD","city":"DECATUR","state":"IL","postal_code":"625215139","country_code":"US","phone":"2178645531","fax":"2178642449"}],"license":{"state":"IL","number":"277000529"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"041292879","state":"IL","issuer":null},{"type_code":"05","label":"Medicaid","value":"036102377 1","state":"IL","issuer":null},{"type_code":"01","label":"Other","value":"433990","state":"IL","issuer":"MEDICARE GROUP"},{"type_code":"05","label":"Medicaid","value":"1497762959 1","state":"IL","issuer":null},{"type_code":"01","label":"Other","value":"P00678744","state":"IL","issuer":"RAILROAD MEDICARE"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20061114000644","type_code":"14-50","type_desc":"PRACTITIONER - NURSE PRACTITIONER","state":"IL","pac_id":"1951309558"}]},"enumeration_date":"2006-11-01","last_updated":"2025-10-28","_meta":{"source":"NPPES","snapshot_date":"2025-10-28","doc_url":"https://findmynpi.com/api"}}