Brunson, Jack Michael

Brunson, Jack Michael is an individual health care provider with primary practice located at 1425 N Randall Rd , Elgin IL 60123-2300. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Brunson, Jack Michael can be contacted via phone (847) 742-9800.

Contact Information

Primary practice address
1425 N Randall Rd Elgin IL 60123-2300
Phone: (847) 742-9800
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 10002688A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 085004840 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085.004840 Illinois

Profile Details

NPI number 1174950661
LBN Legal business name Brunson, Jack Michael
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 30th, 2013
Last updated Mar 22nd, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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