Organization
SPECIALTY PAIN ANESTHESIA REHABILITATION CONSULTANTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN LEUTHNER (OWNER)
(847) 363-0863
Entity
Organization
Contact information
Practice address
256 E GRAND AVE, FOX LAKE, IL 60020-1684
(847) 370-6712
Mailing address
6615 GRAND AVE # 1037, GURNEE, IL 60031-4591
(847) 363-0863
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
10/21/2019
Last updated
08/23/2024
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