Individual
JEREMY BRUNNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1818 E WINDSOR RD, URBANA, IL 61802-9566
(217) 255-9700
Mailing address
611 W PARK ST, URBANA, IL 61801-2501
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085006454
IL
Other
Enumeration date
11/22/2017
Last updated
02/25/2026
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