# PREFERRED PAIN PROVIDERS

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

## Provider details

- **NPI number:** 1679381859
- **Authorized official:** JAMIE VANDENELZEN (OWNER)
- **Authorized official phone:** (920) 217-6052

## Contact information

- **Practice address:** 2651 N LARAMIE AVE, CHICAGO, IL 60639-1613
- **Practice address phone:** (920) 217-6052
- **Mailing address:** 2651 N LARAMIE AVE, CHICAGO, IL 60639-1613

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/20/2024
- **Last updated:** 12/20/2024