KENZIE KITCHAROEN (M.D.) – Psychiatry Physician, NPI 1356533269
Psychiatry Physician
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Profile Insights
NPPES metrics only — not quality of care.
1,382 PSYCHIATRY in IL
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Provider Addresses for KENZIE KITCHAROEN (M.D.)
4, Revere Drive, Woodridge, Highland Park, Northbrook, Cook County, Illinois, 60062, United States
NORTHBROOK, IL 600621558
Phone: (847) 834-1428
Fax: (855) 265-2722
Type: Location
899 SKOKIE BLVD SPC 333
NORTHBROOK, IL 600624023
Phone: (847) 834-1428
Fax: (855) 265-2722
Type: Location
899 Skokie Blvd Spc 333
Northbrook, IL 600624023
Phone: (847) 834-1428
Fax: (855) 265-2722
Type: Location
515 VALLEY ST STE 203
MAPLEWOOD, NJ 070404300
Phone: (908) 663-2929
Fax: (908) 219-6213
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-07-25
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20241107001941 | I | Psychiatry | NY | TBD |
| I20250725001560 | I | Psychiatry | NJ | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60062)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | CA | |
| Emergency Medicine | CA | |
| Physician Assistant | CA | |
| Physician Assistant | TX | |
| Emergency Medicine | OH | |
| Emergency Medicine | NY | |
| Emergency Medicine | CA | |
| Physician Assistant | CA | |
| Emergency Medicine | VA | |
| Nurse Practitioner | NJ |
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