Healthcare Provider Details

I. General information

NPI: 1003964735
Provider Name (Legal Business Name): HORTON OCCUPATIONAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16246 PRINCE DR
SOUTH HOLLAND IL
60473-3233
US

IV. Provider business mailing address

16246 PRINCE DR
SOUTH HOLLAND IL
60473-3233
US

V. Phone/Fax

Practice location:
  • Phone: 708-333-4200
  • Fax: 708-333-8585
Mailing address:
  • Phone: 708-333-4200
  • Fax: 708-333-8585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. BRUCE D HORTON
Title or Position: OWNER
Credential: DO
Phone: 708-333-4200