Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Makenzie Diserio

Individual provider Physician Assistant · NPI 1679146302

Makenzie Diserio is a Physician Assistant in Dekalb, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2021

Practice location Address checks out

1212 S 2nd St
Dekalb, IL 60115-4435
Phone: (872) 231-3162
Fax: (702) 977-1496
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085.009196 (IL)

Record details

NPI number1679146302
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 20, 2021
Last updated in NPPESOctober 10, 2025
Certification dateOctober 10, 2025
Mailing addressPo Box 74008272, Chicago, IL 60674-8272

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