Organization
PREFERRED PAIN PROVIDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE VANDENELZEN (OWNER)
(920) 217-6052
Entity
Organization
Contact information
Practice address
2651 N LARAMIE AVE, CHICAGO, IL 60639-1613
(920) 217-6052
Mailing address
2651 N LARAMIE AVE, CHICAGO, IL 60639-1613
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
12/20/2024
Last updated
12/20/2024
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