# KENILWORTH OPTICAL CO INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134204175
- **Authorized official:** KRISHAN C NAGPAL M.D. (VICE PRESIDENT)
- **Authorized official phone:** (630) 832-3055

## Contact information

- **Practice address:** 135 S ROBERT T PALMER DR, SUITE 25, ELMHURST, IL 60126-3412
- **Practice address phone:** (630) 832-3055
- **Practice address fax:** (630) 832-0927
- **Mailing address:** 135 S ROBERT T PALMER DR, SUITE 25, ELMHURST, IL 60126-3412
- **Mailing address phone:** (630) 832-3055
- **Mailing address fax:** (630) 832-0927

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 1149-7051 | IL | Yes |

## Other

- **Enumeration date:** 10/26/2006
- **Last updated:** 06/04/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 066393001 | KRISHAN C NAGPAL, MD | IL |