Individual provider Active NPI

Melissa Lee Dezoute, PA-C

  • Surgical Physician Assistant
  • Naperville, IL
National Provider Identifier
1669814349
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
085004714 Issued in IL
Practice address
100 Spalding Dr Ste 206
Naperville, IL 60540-6552
Phone
(331) 221-9004
NPI assigned
Jul 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 085004714 IL Primary
Physician Assistant 363A00000X 085004714 IL

Addresses

Primary practice location

100 Spalding Dr Ste 206
Naperville, IL 60540-6552

Mailing address

4201 Winfield Rd
Warrenville, IL 60555-4025

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mdezoute232414@direct.edward.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131001000002 IL Practitioner - Physician Assistant 0143454322 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

100 Spalding Dr
Naperville, IL 60540-6552

1200 S York Rd
Suite 1120
Elmhurst, IL 60126-5626
Phone (630) 527-3200

1200 S York St
Elmhurst, IL 60126-5626
Phone (331) 221-6636

24600 W 127TH St
Plainfield, IL 60585-9507

2650 Ridge Ave
Evanston, IL 60201-1700

801 S Washington St
Naperville, IL 60540-7430
Phone (630) 527-5197

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085004714ILMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Elmhurst Memorial Healthcare CurrentSince Aug 23, 2021 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 15, 2023 Accepting new patients
Elmhurst Memorial Healthcare CurrentSince Aug 23, 2021 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

172 E Schiller St
Elmhurst, IL 60126
Phone (331) 221-6377

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

1225 W Lake St
Melrose Park, IL 60160
Phone (708) 681-3000

100 Spalding Dr
Naperville, IL 60540
Phone (630) 357-2900

100 Spalding Dr
Ste 206
Naperville, IL 60540
Phone (630) 355-6996

100 Spalding Dr
Ste 110
Naperville, IL 60540
Phone (630) 369-1501

4201 Winfield Rd
Warrenville, IL 60555
Phone (331) 221-8000

25 N Winfield Rd
#405
Winfield, IL 60190

Organizations & group practices 4

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

Hospital & facility affiliations 2

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": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1669814349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 WINFIELD RD",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605554025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SPALDING DR STE 206",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406552",
            "telephone_number": "331-221-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEZOUTE",
        "first_name": "MELISSA",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-23",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085004714",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004714",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdezoute232414@direct.edward.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "100 Spalding Dr Ste 206",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605406552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.