LEE MICHAEL DE DORE PA NPI 1790017085

NPI Information

  • NPI: 1790017085
  • Provider Name: LEE MICHAEL DE DORE, PA
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 25 N WINFIELD ROAD
    SUITE 505
    WINFIELD, IL
    ZIP 60190
  • Phone: (630) 682-5653

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NPI Details

Lee Michael De Dore, PA is a surgical physician assistant in Winfield, IL with 17 years of experience. Lee Michael De Dore, PA NPI is 1790017085. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

25 N WINFIELD ROAD
SUITE 505
WINFIELD, IL
ZIP 60190
Phone: (630) 682-5653
Fax: (630) 682-8946

The NPI 1790017085 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • X-ray of shoulder, minimum of 2 views (HCPCS:73030)
  • Injection, methylprednisolone acetate, 40 mg (HCPCS:J1030)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)

The enumeration date for this NPI number is 2/11/2010 and was last updated on 6/16/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AS0400XPhysician AssistantSurgical085003692ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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