Healthcare Provider Details

I. General information

NPI: 1780561027
Provider Name (Legal Business Name): MELISSA ANN HORTON PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2025
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 E NORTHWEST HWY
PALATINE IL
60067-8114
US

IV. Provider business mailing address

100 BURLINGTON CIR APT 202
WHEELING IL
60090-4107
US

V. Phone/Fax

Practice location:
  • Phone: 847-808-8884
  • Fax:
Mailing address:
  • Phone: 815-263-4882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085.011507
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: