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1366579054
KENILWORTH MEDICAL ASSOCIATES, S.C.
KENILWORTH, IL
NPI
1366579054
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Entity Type
Organization
Authorized Contact
PAUL DETJEN
President
847-256-5505
Organization Subpart ?
No
Primary Taxonomy
207K00000X Allergy & Immunology
(Licence: IL 036072795)
Enumeration Date
2007-02-28
Last Update Date
2014-11-20
Business Address
KENILWORTH MEDICAL ASSOCIATES, S.C.
534 GREEN BAY RD
KENILWORTH, IL 60043-1801
Phone number: 847-256-5505
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Mailing Address
KENILWORTH MEDICAL ASSOCIATES, S.C.
534 GREEN BAY RD
KENILWORTH, IL 60043-1801
Phone number: 847-256-5505
Copy
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