MEDICARE: YANLING LI GOULD MA, MSC.

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
1	171R00000X	Interpreter		IL

General Provider Information

NPI Number	:	1184957581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YANLING LI GOULD MA, MSC.

Provider Business Mailing Address
First Line	:	2423 W HARRISON ST
Second Line	:	UNIT 1
City	:	CHICAGO
State	:	IL
Zip	:	60612-3524
Country	:	US
Telephone Number	:	312-666-1977
Fax Number	:

Provider Business Practice Location Address
First Line	:	2423 W HARRISON ST
Second Line	:	UNIT 1
City	:	CHICAGO
State	:	IL
Zip	:	60612-3524
Country	:	US
Telephone Number	:	312-666-1977
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2009
Last Update Date	:	09/16/2009

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