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KEVIN KHAMVONGSA
NPI 1467907170
Community/Behavioral Health in Crystal Lake, IL

Active since August 23, 2016
145 S VIRGINIA ST, CRYSTAL LAKE, IL 60014(815) 444-9999 Get Directions Write a Review

NPPES record last updated: August 23, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kevin Khamvongsa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEVIN KHAMVONGSA (NPI 1467907170) is an individual community/behavioral health provider in Crystal Lake, Illinois, licensed in Illinois (S4S8C5H5) and active in the NPI registry since August 2016.

NPPES Registry Identity

NPI1467907170
Entity TypeIndividualMale
Primary Taxonomy251S00000X
Provider Legal NameKEVIN KHAMVONGSA
Location Address145 S VIRGINIA STCrystal Lake, IL 60014-7226
Mailing Address145 S Virginia StCrystal Lake, IL 60014-7226 · (815) 444-9999
Phone(815) 444-9999
Sole ProprietorYes
Enumeration DateAugust 23, 2016
✔ NPI 1467907170 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
License✔ Licensed in IL · S4S8C5H5
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
145 S VIRGINIA ST, Crystal Lake, IL 60014
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANGELICA SOTO MSN,APRN,PMHNP-C
Nurse Practitioner (Psychiatric/Mental Health)
145 S VIRGINIA ST
CRYSTAL LAKE, IL 60014
McHenry County (815) 444-9999
EMILY ANNE CORSON
Social Worker (Clinical)
145 S VIRGINIA ST
CRYSTAL LAKE, IL 60014
McHenry County (815) 444-9999
MICHAEL THIEL
Counselor (Professional)
145 S VIRGINIA ST
CRYSTAL LAKE, IL 60014
McHenry County (815) 397-7654
DR. RAMESH BABU VEMURI M.D.
Psychiatry & Neurology (Psychiatry)
145 S VIRGINIA ST
CRYSTAL LAKE, IL 60014
McHenry County (815) 444-9999
STEPHANIE ROUSE
Social Worker (Clinical)
145 S VIRGINIA ST
CRYSTAL LAKE, IL 60014
McHenry County (815) 444-9999
DONNA LYNN DEROSE APN
Nurse Practitioner (Psychiatric/Mental Health)
145 S VIRGINIA ST
CRYSTAL LAKE, IL 60014
McHenry County (815) 444-9999
MATHERS CLINIC LLC
Psychiatry & Neurology (Psychiatry)
145 S VIRGINIA ST
CRYSTAL LAKE, IL 60014
McHenry County (815) 444-9999
ANDREW TAIT GORDINIER
Counselor
145 S VIRGINIA ST
CRYSTAL LAKE, IL 60014
McHenry County (815) 444-9999

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Khamvongsa's NPI number?

The NPI number for Kevin Khamvongsa is 1467907170. It was assigned to this individual provider in the NPPES registry on August 23, 2016.

Where is Kevin Khamvongsa located?

Kevin Khamvongsa practices at 145 S Virginia St, Crystal Lake, IL 60014. The listed phone number is (815) 444-9999.

What is Kevin Khamvongsa's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

When was this NPI record last updated?

The NPPES record for Kevin Khamvongsa was last updated on August 23, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.