Provider Demographics
NPI:1013754795
Name:GOULD, GRACE (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:GOULD
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1247 W MADISON ST UNIT 304
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-0800
Mailing Address - Country:US
Mailing Address - Phone:262-237-9580
Mailing Address - Fax:
Practice Address - Street 1:1920 WAUKEGAN RD STE 212
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-1700
Practice Address - Country:US
Practice Address - Phone:847-604-0027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist