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General NPI Number Information
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NPI Number | 1033224183
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Entity Type | Individual
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Provider Name | CATHLEEN M GOULD M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 08/07/2018
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Provider Practice Location Address
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Address Line | 101 N MARION ST STE 208
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City | OAK PARK
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State | IL
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Zip | 60301
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Country | US
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Telephone | 312-248-2632
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Fax |
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Provider Business Mailing Address
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Address Line | 1113 S RIDGELAND AVE
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City | OAK PARK
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State | IL
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Zip | 60304-2125
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Country | US
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Telephone | 630-291-0719
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 336089933
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License Number State | IL
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