Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kevin Khamvongsa

Individual provider Community/Behavioral Health Agency · NPI 1467907170

Kevin Khamvongsa is a Community/Behavioral Health Agency in Crystal Lake, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2016

Practice location Address checks out

145 S Virginia St
Crystal Lake, IL 60014-7226
Phone: (815) 444-9999
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Behavioral Health Agency (primary) Taxonomy 251S00000X · Licence S4S8C5H5 (IL)

Record details

NPI number1467907170
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 23, 2016
Last updated in NPPESAugust 23, 2016
Mailing address145 S Virginia St, Crystal Lake, IL 60014-7226

Other providers in Crystal Lake