IndividualActive
Elysa Widjaja, MD
NPI 1184331522 · Pediatric Radiology Physician · Cincinnati, OH
Provider details
- NPI number
- 1184331522
- Entity type
- Individual
- Primary specialty
- Pediatric Radiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Female
- Sole proprietor
- Yes
- License
- 036.161747 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
3333 Burnet Ave
Ml 5031
Cincinnati, OH 45229-3026
Phone: (513) 636-4251
Fax: (513) 636-8145
Approximate (ZIP-level) locationGet directions
Mailing address
3333 Burnet Ave
Cincinnati, OH 45229-3026
Additional practice locations (2)
- Lurie Children'S Hospital225 E. Chicago AvenueChicago, IL 60611Phone: (312) 227-3475Fax: (312) 227-9783
- 676 N Saint Clair St Ste 800Chicago, IL 60611-2978Phone: (312) 695-5753Fax: (312) 695-5645
Registry dates
- Enumerated
- 2022-11-04
- Last updated
- 2026-02-12
- Certified
- 2026-02-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.