Individual provider Active NPI

Vivian Adeck Ndangoh-Tendong, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Aurora, IL
National Provider Identifier
1962075473
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209026958 Issued in IL
Practice address
70 S River St
Aurora, IL 60506-5185
Phone
(630) 844-2662
Fax
(630) 844-3084
NPI assigned
Jul 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 041417477 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209026958 IL Primary

Addresses

Primary practice location

70 S River St
Aurora, IL 60506-5185

Mailing address

2500 Concord CT
Montgomery, IL 60538-5042
Phone (630) 340-0276

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240409002016 IL Practitioner - Nurse Practitioner 9436597507 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Counseling Service of AuroraGroup PAC ID 5294811535, 11 clinicians

Practice addresses (Care Compare)

70 S River St
Aurora, IL 60506-5185
Phone (630) 844-2662

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041417477ILMDCommunity Health Registered Nurse
209026958ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Open Door Clinic CurrentSince Sep 13, 2024 Accepting new patients
Open Door Clinic of Greater Elgin Current Accepting new patients
Family Counseling Service of Aurora CurrentSince Feb 4, 2024 Accepting new patients
Family Counseling Service of Aurora CurrentSince Feb 4, 2024 Accepting new patients
Psychelp Counseling & Psychiatry Past Accepting new patients

Locations

70 S River St
Aurora, IL 60506
Phone (630) 844-2662

157 S Lincoln Ave
Ste K
Aurora, IL 60505
Phone (847) 695-1093

1665 Larkin Ave
Elgin, IL 60123
Phone (847) 695-1093

Interoperability endpoints

  • Direct secure messaging: vivian.ndangoh.1@17509.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1962075473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 CONCORD CT",
            "city": "MONTGOMERY",
            "state": "IL",
            "postal_code": "605385042",
            "telephone_number": "630-340-0276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 S RIVER ST",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605065185",
            "telephone_number": "630-844-2662",
            "fax_number": "630-844-3084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDANGOH-TENDONG",
        "first_name": "VIVIAN",
        "middle_name": "ADECK",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-22",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "IL",
            "license": "041417477",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209026958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.