Provider Demographics
NPI:1982915120
Name:BERGMANN, LIISA L (MD)
Entity type:Individual
Prefix:DR
First Name:LIISA
Middle Name:L
Last Name:BERGMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:W180N8085 TOWN HALL RD
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-3518
Mailing Address - Country:US
Mailing Address - Phone:262-257-3060
Mailing Address - Fax:262-253-7197
Practice Address - Street 1:W180N8085 TOWN HALL RD
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-3518
Practice Address - Country:US
Practice Address - Phone:262-257-3060
Practice Address - Fax:262-253-7197
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI69214-202085R0202X
KY565552085R0202X
TXS70082085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIMDR-5907OtherSTATE MEDICAL LICENSE NUMBER