Michael Brunner, DO
Individual provider Active NPI Family Medicine Physician · Bartlett, IL
NPI 1215166319 · NPPES record last updated Mar 11, 2021
Key facts
- NPI
- 1215166319
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036.133928 (IL)
- Practice address
- 1041 W Stearns Rd
Bartlett, IL 60103-4509 - Phone
- (630) 716-7500
- NPI assigned
- Jul 9, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Midwestern University College of Dental Medicine, Glendale, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Bonaventure Medical Foundation LLC
Practice addresses (Care Compare)
1041 W Stearns Rd
Bartlett, IL 60103-4509
Phone (630) 716-7500
1786 Moon Lake Blvd
Hoffman Est, IL 60194-5029
Phone (847) 755-8208
Hospital & facility affiliations
- St Alexius Medical Center
- Alexian Brothers Medical Center 1
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140715001536 | IL | Practitioner - Family Practice | 2961627591 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.133928 | IL | MD | Family Medicine Physician |
| 125055948 | IL | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bonaventure Medical Foundation, LLC | Family Medicine | Current |
Accepting new patients |
Locations
1041 W Stearns Rd
Bartlett, IL 60103
Phone (630) 372-9015
1515 E Lake St
Hanover Park, IL 60133
Phone (630) 483-3200
1786 Moon Lake Blvd
Hoffman Estates, IL 60169
Phone (847) 640-5640
190 W Irving Park Rd
Wood Dale, IL 60191
Phone (630) 766-0412
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036.133928 | IL | Yes |
| Student in an Organized Health Care Education/Training Program | 390200000X | 125055948 | IL |
Addresses
Primary practice location
1041 W Stearns Rd
Bartlett, IL 60103-4509
Mailing address
1515 E Lake St
Attn: Abmg Primary Care
Hanover Park, IL 60133-4869
Phone (630) 483-3200
Other practice location 1
1515 E Lake St
Attn: Abmg Primary Care
Hanover Park, IL 60133-4869
Phone (630) 483-3200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 125055948 | Other | IL | STATE LICENSE |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | michael.brunner.1@380.direct.athenahealth.com |
Other providers in Bartlett, IL
- Brewster Creek Speech and Language Therapy
- Patricia Brillo
- Kristie Brockway
- Katherine Lynn Brookhart
- Erin Brumfield Grima
- Kenneth Lee Bryan Jr.
- Jennifer L. Bryant
- Theresa Ann Bull
- Leslie Burke
- Muhammad Moazzam Iqbal Butt
All providers in Bartlett, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.