Provider Demographics
NPI:1619722832
Name:WIGGLES THERAPY, PLLC
Entity Type:Organization
Organization Name:WIGGLES THERAPY, PLLC
Other - Org Name:WIGGLES THERAPY, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/LEAD PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIVANI
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:248-219-1607
Mailing Address - Street 1:1301 W MADISON ST APT 519
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-1946
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:133 S ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-2485
Practice Address - Country:US
Practice Address - Phone:312-288-0020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty