Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kenilworth Medical Associates, SC

Organization Allergy & Immunology Physician · NPI 1366579054

Kenilworth Medical Associates, SC is an Allergy & Immunology Physician in Kenilworth, Illinois. Licensed in Illinois. Registered with an NPI since 2007.

Licensed in
IL
In the registry since
2007

Practice location Address checks out

534 Green Bay Rd
Kenilworth, IL 60043-1801
Phone: (847) 256-5505
Fax: (847) 256-5567
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Allergy & Immunology Physician (primary) Taxonomy 207K00000X · Licence 036072795 (IL)

Record details

NPI number1366579054
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Paul Detjen — President · (847) 256-5505
NPI enumeratedFebruary 28, 2007
Last updated in NPPESNovember 20, 2014
Mailing address534 Green Bay Rd, Kenilworth, IL 60043-1801

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