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BERNADETA LEEGAN WIBISONO M.D.
NPI 1003143504
Pediatrics in Chicago, IL

Active since November 04, 2009
2951 S KING DR APT 1004, CHICAGO, IL 60616(312) 351-1346 Get Directions Write a Review

NPPES record last updated: November 4, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Bernadeta Leegan Wibisono M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BERNADETA LEEGAN WIBISONO M.D. (NPI 1003143504) is an individual pediatrics provider in Chicago, Illinois, licensed in Illinois (125055427) and active in the NPI registry since November 2009.

NPPES Registry Identity

NPI1003143504
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameBERNADETA LEEGAN WIBISONOCredential: M.D.
Location Address2951 S KING DR APT 1004Chicago, IL 60616-3359
Mailing Address2951 S King Dr Apt 1004Chicago, IL 60616-3359
Phone(312) 351-1346
Sole ProprietorYes
Enumeration DateNovember 4, 2009
✔ NPI 1003143504 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in IL · 125055427
Definition
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.
2951 S KING DR APT 1004, Chicago, IL 60616
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bernadeta Wibisono's NPI number?

The NPI number for Bernadeta Wibisono is 1003143504. It was assigned to this individual provider in the NPPES registry on November 4, 2009.

Where is Bernadeta Wibisono located?

Bernadeta Wibisono practices at 2951 S King Dr Apt 1004, Chicago, IL 60616. The listed phone number is (312) 351-1346.

What is Bernadeta Wibisono's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

When was this NPI record last updated?

The NPPES record for Bernadeta Wibisono was last updated on November 4, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.