Healthcare Provider Details

I. General information

NPI: 1194649657
Provider Name (Legal Business Name): POCKET FULL OF WIGGLES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1531 ELYSIUM DR
MINOOKA IL
60447-4701
US

IV. Provider business mailing address

1531 ELYSIUM DR
MINOOKA IL
60447-4701
US

V. Phone/Fax

Practice location:
  • Phone: 847-370-7685
  • Fax:
Mailing address:
  • Phone: 847-370-7685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: ALANA HANSEN
Title or Position: OWNER
Credential: OTR/L
Phone: 847-370-7685