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
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
05/05/2006
Last updated
09/11/2025
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