MEDICARE: ALEXANDRA GOLD

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	235Z00000X	Speech-Language Pathologist		IL

General Provider Information

NPI Number	:	1386503878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA GOLD

Provider Business Mailing Address
First Line	:	3319 N ELSTON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-5811
Country	:	US
Telephone Number	:	312-733-0883
Fax Number	:

Provider Business Practice Location Address
First Line	:	3319 N ELSTON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-5811
Country	:	US
Telephone Number	:	312-733-0883
Fax Number	:

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

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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Directions to “ ALEXANDRA GOLD ” Practice Location

Language	Start Address	Practice Location

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