Kenilworth Medical Associates, S.c.

NPI #1366579054 in Kenilworth, Illinois

Provider Information

NPI Number: 1366579054
Entity Type: Organization
Organization Name: Kenilworth Medical Associates, S.c.
Primary Specialty: Allergy & Immunology
Enumeration Date: Feb 28, 2007
Last Updated: Nov 20, 2014

Practice Location

Address: 534 GREEN BAY RD
City: Kenilworth
State: Illinois
ZIP Code: 60043-1801
Phone: (847) 256-5505

Authorized Official

Name: DR. PAUL DETJEN, MD
Title: PRESIDENT
Phone: (847) 256-5505

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Allergy & Immunology	207K00000X	Primary

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