Healthcare Provider Details

I. General information

NPI: 1053131367
Provider Name (Legal Business Name): A NUGGET OF KNOWLEDGE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2024
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

647 HARBOR TER
BARTLETT IL
60103-4832
US

IV. Provider business mailing address

647 HARBOR TER
BARTLETT IL
60103-4832
US

V. Phone/Fax

Practice location:
  • Phone: 630-220-0181
  • Fax:
Mailing address:
  • Phone: 630-220-0181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NICOLE NUGENT
Title or Position: OWNER
Credential: MOT, OTR/L
Phone: 630-220-0181