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NPI Code Detail

MEDICARE: SARAH ROSE GOULD

MEDICARE: SARAH ROSE GOULD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist070.039821IL

General Provider Information

NPI Number : 1093646580
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH ROSE GOULD
Provider Business Mailing Address
First Line : 644 W ARLINGTON PL APT 4B
Second Line :
City : CHICAGO
State : IL
Zip : 60614-2657
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 719 N MARION ST
Second Line :
City : OAK PARK
State : IL
Zip : 60302-1530
Country : US
Telephone Number : 844-478-6878
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2026
Last Update Date : 05/26/2026

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Directions to “ SARAH ROSE GOULD ” Practice Location

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