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Individual

RACHELLE GOLD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
7101 N. CICERO AVE., SUITE 203, LINCOLNWOOD, IL 60712-2112
(773) 991-7224
(773) 338-6976
Mailing address
4801 W PETERSON AVE, STE. 612, CHICAGO, IL 60646-5713
(773) 338-6976
(773) 338-6976

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071006126
IL
103TC0700X
Clinical Psychologist
071006126
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1632418
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/24/2006
Last updated
01/12/2012
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