NPIMap

Individual provider Active NPI

Melissa Nicole Dattalo, MD, MPH

  • Geriatric Medicine (Internal Medicine) Physician
  • Wheaton, IL
National Provider Identifier
1578705067
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
036173580 Issued in IL
Practice address
1800 N Main St Ste 219
Wheaton, IL 60187-3112
Phone
(630) 614-4960
Fax
(630) 682-3727
NPI assigned
Mar 30, 2009
Last updated
Aug 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036173580 IL
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 60700-20 WI
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 036173580 IL Primary

Addresses

Primary practice location

1800 N Main St Ste 219
Wheaton, IL 60187-3112

Mailing address

1800 N Main St Ste 219
Wheaton, IL 60187-3112
Phone (630) 614-4960

Other identifiers 1

IdentifierTypeStateIssuer
055690400MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250212002281 IL Practitioner - Internal Medicine 7214192756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Johns Hopkins University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as group
Quality
87.78
Promoting interoperability
77
Improvement activities
40
Cost
75.8

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036173580ILMDInternal Medicine Physician
60700-20WIMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Internal Medicine CurrentSince Feb 28, 2025 Accepting new patients
Central Dupage Physician Group CurrentSince Feb 28, 2025 Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

1800 N Main St
Ste 219
Wheaton, IL 60187
Phone (630) 614-4960

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1578705067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 N MAIN ST STE 219",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873112",
            "telephone_number": "630-614-4960",
            "fax_number": "630-682-3727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N MAIN ST STE 219",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873112",
            "telephone_number": "630-614-4960",
            "fax_number": "630-682-3727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATTALO",
        "first_name": "MELISSA",
        "middle_name": "NICOLE",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-30",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036173580",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "WI",
            "license": "60700-20",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036173580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055690400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.