OrganizationActive
Kenilworth Medical Associates, S.c.
NPI 1366579054 · Allergy & Immunology Physician · Kenilworth, IL
Provider details
- NPI number
- 1366579054
- Entity type
- Organization
- Primary specialty
- Allergy & Immunology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Paul Detjen, President(847) 256-5505
- License
- 036072795 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
534 Green Bay Rd
Kenilworth, IL 60043-1801
Phone: (847) 256-5505
Fax: (847) 256-5567
Approximate (ZIP-level) locationGet directions
Mailing address
534 Green Bay Rd
Kenilworth, IL 60043-1801
Registry dates
- Enumerated
- 2007-02-28
- Last updated
- 2014-11-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.