Jorge E Brunelle, Md, Mph, Pc | |
120 S Lincoln Ave Aurora IL 60505-4228 | |
(630) 801-4150 | |
(630) 801-4151 |
Full Name | Jorge E Brunelle, Md, Mph, Pc |
---|---|
Speciality | Internal Medicine |
Location | 120 S Lincoln Ave, Aurora, Illinois |
Authorized Official Name and Position | Jorge E Brunelle (PRESIDENT/OWNER) |
Authorized Official Contact | 6308014150 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Jorge E Brunelle, Md, Mph, Pc 120 S Lincoln Ave Aurora IL 60505-4228 Ph: (630) 801-4150 | Jorge E Brunelle, Md, Mph, Pc 120 S Lincoln Ave Aurora IL 60505-4228 Ph: (630) 801-4150 |
NPI Number | 1710067962 |
---|---|
Provider Enumeration Date | 10/16/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 4385644533 |
---|---|
Medicare Enrollment ID | O20070111000364 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710067962 | NPI | - | NPPES |
0036-097428 | Other | IL | LICENSE NUMBER |
36097428 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 0036-097428 (Illinois) | Primary |
Provider Name | Jorge E Brunelle |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1164443438 PECOS PAC ID: 6901804020 Enrollment ID: I20061207000030 |
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