Individual provider Active NPI

Luke Anthony Horton

  • MOHS-Micrographic Surgery Physician
  • Orland Park, IL
National Provider Identifier
1619554672
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
94265 Issued in SC
Practice address
16105 S la Grange Rd
Orland Park, IL 60467-5503
Phone
(708) 636-3767
NPI assigned
Mar 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 94265 SC Primary

Addresses

Primary practice location

16105 S la Grange Rd
Orland Park, IL 60467-5503

Mailing address

38W335 Christina CT
Batavia, IL 60510-9528
Phone (630) 862-8862

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, SC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230906004309 CA Order and Referring Only - DermatologyPractitioner - Dermatology 8921462169
I20250924000170 SC Order and Referring Only - Micrographic Dermatologic Surgery (MDS)Practitioner - Micrographic Dermatologic Surgery (MDS) 8921462169

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1619554672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38W335 CHRISTINA CT",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605109528",
            "telephone_number": "630-862-8862",
            "fax_number": "630-761-8724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16105 S LA GRANGE RD",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675503",
            "telephone_number": "708-636-3767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORTON",
        "first_name": "LUKE",
        "middle_name": "ANTHONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-25",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "SC",
            "license": "94265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.