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Organization
GREAT LAKE PAIN PHYSICIANS, LTD.
Active
Organization
GREAT LAKE PAIN PHYSICIANS, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENDALL R. LUTZ (BILLING MANAGER)
(847) 836-7015
Entity
Organization
Contact information
Practice address
200 S GREENLEAF ST, SUITE A, GURNEE, IL 60031-3398
(847) 244-6464
Mailing address
185 PENNY AVE, EAST DUNDEE, IL 60118-1454
(847) 836-7015
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
NULL
207L00000X
Anesthesiology Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
NULL
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
05/05/2006
Last updated
09/11/2025
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