Individual provider · Type 1 NPI
Melissa Kate Modro, PA-C
Surgical Physician Assistant · Highland Park, IL
NPI number
1104453638
Active
Practice location
777 Park Ave W Ste B131A
Highland Park, IL 60035-2433
Fax (847) 926-5351
Mailing address
2650 Ridge Ave Ste 1223
Evanston, IL 60201-1700
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | 085007824 (IL) |
| Physician Assistant | 363A00000X | 085007824 (IL) |
Surgical Physician Assistant: Definition to come...
Another provider at this address
Other surgical physician assistant providers in Highland Park
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- Rebecca F. Nishimoto, PA-CSurgical Physician Assistant Highland Park, IL NPI 1073624664
- Angela Marie Pecora, PA-CSurgical Physician Assistant Highland Park, IL NPI 1144974346
- Andrea Marie Fonacier, PA-CSurgical Physician Assistant Highland Park, IL NPI 1255831426
- Elizabeth Ashley Hindman, PA-C, MSSurgical Physician Assistant Highland Park, IL NPI 1366758096
- Gabriel Anthony Rahhal, PA-CSurgical Physician Assistant Highland Park, IL NPI 1457681553
- Lyndsey Rae Bassett, PA-CSurgical Physician Assistant Highland Park, IL NPI 1518725993
- James Patrick O'Malley, PA-CSurgical Physician Assistant Highland Park, IL NPI 1568849347
About NPI 1104453638
Melissa Kate Modro, PA-C's National Provider Identifier is 1104453638, issued on Mar 25, 2020. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Highland Park, IL. The record was last updated on Mar 24, 2026.