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Bernadeta Wibisono, M.D
NPI 1003143504 · on the registry since 2009 · sole proprietor
Practice
- Address
- 2951 S King Dr Apt 1004
Chicago, IL 60616 - Phone
- (312) 351-1346
- Organisation at this address
- Caleb Demarais Counseling, Pllc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- Pediatrics Physician
208000000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2009-11-04
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois