Healthcare Provider Details

I. General information

NPI: 1124257571
Provider Name (Legal Business Name): JOHN BRUNETTI, DMD, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2009
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 E PHILLIP RD SUITE 101
VERNON HILLS IL
60061-1858
US

IV. Provider business mailing address

1 E PHILLIP RD STE 101
VERNON HILLS IL
60061-1858
US

V. Phone/Fax

Practice location:
  • Phone: 847-367-4190
  • Fax: 847-367-5010
Mailing address:
  • Phone: 847-367-4190
  • Fax: 847-367-5010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number019025890
License Number StateIL

VIII. Authorized Official

Name: JOHN BRUNETTI
Title or Position: PRESIDENT
Credential:
Phone: 847-367-4190