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General NPI Number Information
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NPI Number | 1992623888
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Entity Type | Individual
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Provider Name | AMANDA KATHLEEN GOLD MSN, RN
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Gender | Female
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Dates
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Enumeration Date | 07/08/2026
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Last Update Date | 07/08/2026
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Provider Practice Location Address
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Address Line | 801 S MILWAUKEE AVE
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-3204
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Country | US
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Telephone | 847-990-5526
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Fax |
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Provider Business Mailing Address
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Address Line | 1650 PENN CT
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City | CRYSTAL LAKE
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State | IL
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Zip | 60014-2710
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Country | US
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Telephone | 224-623-4577
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041.4464167
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License Number State | IL
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