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Bernadeta Wibisono, M.D.
NPI 1003143504 · Pediatrics Physician · Chicago, IL
Bernadeta Wibisono, M.D. is a Pediatrics Physician provider in Chicago, IL (NPI 1003143504).
Provider details
- NPI number
- 1003143504
- Entity type
- Individual
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- Yes
- License
- 125055427 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(84/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2951 S King Dr Apt 1004
Chicago, IL 60616-3359
Phone: (312) 351-1346
Street-level locationGet directions
Mailing address
2951 S King Dr Apt 1004
Chicago, IL 60616-3359
Registry dates
- Enumerated
- 2009-11-04
- Last updated
- 2009-11-04
Frequently asked questions
- What is Bernadeta Wibisono's NPI number?
- Bernadeta Wibisono's National Provider Identifier (NPI) is 1003143504, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Bernadeta Wibisono's specialty?
- Bernadeta Wibisono is listed in the NPPES registry with a primary specialty of Pediatrics Physician (Allopathic & Osteopathic Physicians).
- Where is Bernadeta Wibisono located?
- Bernadeta Wibisono's practice location on file with NPPES is 2951 S King Dr Apt 1004, Chicago, IL 60616-3359.
- What is Bernadeta Wibisono's phone number?
- The practice phone number listed in the NPPES registry for Bernadeta Wibisono is (312) 351-1346.
- Is Bernadeta Wibisono's NPI active?
- Yes — Bernadeta Wibisono's NPI (1003143504) is active in the NPPES registry as of the last update on 2009-11-04.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.