Provider Demographics
NPI:1073674784
Name:LIBER, PETER IHOR (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:IHOR
Last Name:LIBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 E LOOP RD
Mailing Address - Street 2:301
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187
Mailing Address - Country:US
Mailing Address - Phone:630-690-7300
Mailing Address - Fax:630-690-8019
Practice Address - Street 1:55 E LOOP RD
Practice Address - Street 2:301
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187
Practice Address - Country:US
Practice Address - Phone:630-690-7300
Practice Address - Fax:630-690-8019
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics