| 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 | Family 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 | 03/11/2025 |
| 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 |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | 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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