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General NPI Number Information
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NPI Number | 1982915120
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Entity Type | Individual
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Provider Name | LIISA L BERGMANN M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/22/2010
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | W180N8085 TOWN HALL RD
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City | MENOMONEE FALLS
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State | WI
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Zip | 53051-3518
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Country | US
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Telephone | 262-257-3060
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Fax | 262-253-7197
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Provider Business Mailing Address
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Address Line | W180N8085 TOWN HALL RD
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City | MENOMONEE FALLS
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State | WI
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Zip | 53051-3518
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Country | US
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Telephone | 262-257-3060
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Fax | 262-253-7197
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 69214-20
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 56555
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | S7008
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License Number State | TX
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