MEDICARE: JORGE E BRUNELLE, MD, MPH, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0036-097428	OTHER	IL	LICENSE NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710067962
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JORGE E BRUNELLE, MD, MPH, PC

Provider Business Mailing Address
First Line	:	120 S LINCOLN AVE
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60505-4228
Country	:	US
Telephone Number	:	630-801-4150
Fax Number	:	630-801-4151

Provider Business Practice Location Address
First Line	:	120 S LINCOLN AVE
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60505-4228
Country	:	US
Telephone Number	:	630-801-4150
Fax Number	:	630-801-4151

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	JORGE E BRUNELLE
Credential	:	M.D, M.P.H, PC
Telephone Number	:	630-801-4150

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	03/11/2025

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