Unknown Individual – Psychiatry Physician, NPI 1780643387

Unknown Individual is a healthcare provider. based in Kalamazoo, Michigan. specializing in Psychiatry Physician. They hold a License No. 4301065094 (MI). The NPI Number for Unknown Individual is 1780643387

Main info

Organization
Inactive
52 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1780643387
Phone
Not provided
Address
1000 OAKLAND DRIVE
Deactivation Date
2 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2693376373
Graduation Year
1974 (52 years ago)
PAC ID
9133016231
Group Practice PAC ID
7517113954
Professional Enrollment ID
I20040303000324
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 1000, Oakland Drive, Kalamazoo, Kalamazoo County, Michigan, 49008, United States

    KALAMAZOO, MI 490081282

    Phone:

    Type: Mailing

  • 1717, Shaffer Street, Eastwood, Kalamazoo Charter Township, Kalamazoo County, Michigan, 49048, United States

    SUITE 010

    KALAMAZOO, MI 490481647

    Phone: (269) 337-6373

    Fax: (269) 337-6376

    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.

No Medicare enrollment or revalidation data available for this provider in our database.

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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 49008)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7517113954View full group profile
NameSpecialtyState
DR. SUMMER SAMIR CHAHIN (PH.D.)
Clinical PsychologistMI
SUSAN EMILY JEVERT-EICHORN (DO)
-MI
LAUREN PIPER (DO)
Family Practice, Obstetrics/GynecologyMI
RICHARD R ROACH (M.D.)
-MI
BENJAMIN S. AVNER (MD)
Infectious DiseaseMI
MARITZA E LAGOS-SAEZ (M.D.)
P S Y C H I A T R YMI
JORDAN WROBLEWSKI
O B S T E T R I C S/ G Y N E C O L O G YMI
MICHAEL JAMES REDINGER (MD)
P S Y C H I A T R YMI
CAMERON T SCHAECHER (MD)
Internal MedicineMI
PETER J ZIEMKOWSKI (M.D.)
-MI

Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1780643387 if you need a stable reference for Unknown Individual.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What kind of provider is Unknown Individual?
The page reflects Psychiatry Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Michigan?
You will see Kalamazoo, Michigan on file for Unknown Individual alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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