Healthcare Provider Details

I. General information

NPI: 1497383921
Provider Name (Legal Business Name): ZINA CHAKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 06/22/2025
Certification Date: 06/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 LIVERNOIS RD
TROY MI
48083-1214
US

IV. Provider business mailing address

1 FORD PL
DETROIT MI
48202-3450
US

V. Phone/Fax

Practice location:
  • Phone: 248-680-6000
  • Fax:
Mailing address:
  • Phone: 313-874-4806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number5101028551
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: