Kevin Khamvongsa
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 StCrystal Lake, IL 60014-7226
Phone: (815) 444-9999
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Specialties & licences
| Community/Behavioral Health Agency (primary) | Taxonomy 251S00000X · Licence S4S8C5H5 (IL) |
|---|
Record details
| NPI number | 1467907170 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | August 23, 2016 |
| Last updated in NPPES | August 23, 2016 |
| Mailing address | 145 S Virginia St, Crystal Lake, IL 60014-7226 |
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