Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JACK MICHAEL BRUNSON, PA-C
ActiveMR. JACK MICHAEL BRUNSON, PA-C is a Physician Assistant healthcare provider located in ELGIN, Illinois. NPI 1174950661 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · ELGIN, IL
Registration Details
- NPI Number
- 1174950661
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 30, 2013 (12.862652574883 yrs)
- Last Updated
- Nov 24, 2025
- Licenses
-
085004840 (IL)085.004840 (IL)10002688A (IN)853623 (WI)
Practice Information
- Address
-
1425 N RANDALL RDELGIN, IL, 601232300Browse IL providers · Browse ZIP 60123
- Phone
- 8477429800
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Physician Assistant
- Additional Specialty
- Physician Assistant
- Additional Specialty
- Physician Assistant
Other Physician Assistant Providers in ELGIN, IL
| Name | Credential | NPI |
|---|---|---|
| MR. ADAM MICHAEL MOLLSEN | PA-C | 1639140338 |
| SILVIA YUNG | PA | 1700839651 |
| THOMAS J LEWANDOWSKI | PA-C | 1144328741 |
| EILEEN JAN OESER | PA-C | 1316034861 |
| CARRIE S FORTMAN | PAC | 1336211549 |
| MR. JASON J GRAF | PA-C | 1942372537 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.