Bernadeta Leegan Wibisono, M.D.

NPI #1003143504 in Chicago, Illinois

Provider Information

NPI Number
1003143504
Entity Type
Individual
Name
Bernadeta Leegan Wibisono, M.D.
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Pediatrics
Credential
M.D.
Enumeration Date
Nov 4, 2009
Last Updated
Nov 4, 2009

Practice Location

Address
2951 S KING DR APT 1004
ZIP Code
60616-3359
Phone
(312) 351-1346

Specialties & Taxonomy Codes

Specialty
Pediatrics

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