Individual
CERES K KANGOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN-CNP
Contact information
Practice address
9697 191ST ST. SUITE 200, EHMG-BEHAVIORAL HEALTH, MOKENA, IL 60448
(630) 646-6540
(630) 646-6542
Mailing address
1111 W LAKE ST, ADDISON, IL 60101-1197
(630) 682-7400
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
277002135
IL
363LF0000X
Family Nurse Practitioner
209019061
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
277002135
IL
Other
Enumeration date
03/24/2019
Last updated
04/09/2026
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