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BERNADETA LEEGAN WIBISONO M.D. NPI 1003143504


NPI Information

NPI: 1003143504
Provider Name: BERNADETA LEEGAN WIBISONO, M.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual
Address:
2951 S KING DR APT 1004
CHICAGO, IL
ZIP 60616
Phone: (312) 351-1346
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Bernadeta Leegan Wibisono, M.D. is a pediatrics in Chicago, IL. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. Bernadeta Leegan Wibisono, M.D. NPI is 1003143504. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2951 S KING DR APT 1004
CHICAGO, IL
ZIP 60616-359
Phone: (312) 351-1346

The enumeration date for this NPI number is 11/4/2009 and was last updated on 11/4/2009.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics125055427ILLINOISYes

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: 4/28/2024

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