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KATHERINE ANNE WIDERBORG MD
NPI 1588757579
Surgery in Normal, IL

Active since October 02, 2006
1537 FORT JESSE RD, SUITE A, NORMAL, IL 61761(309) 808-0122(309) 808-0552 Get Directions Write a Review

NPPES record last updated: March 12, 2013. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Katherine Anne Widerborg Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATHERINE ANNE WIDERBORG MD (NPI 1588757579) is an individual surgery provider in Normal, Illinois, licensed in Illinois (036-068927) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1588757579
Entity TypeIndividualFemale
Primary Taxonomy208600000X
Provider Legal NameKATHERINE ANNE WIDERBORGCredential: MD
Location Address1537 FORT JESSE RD, SUITE ANormal, IL 61761
Mailing Address1505 Eastland Dr, Suite 2300Bloomington, IL 61701-3534 · (309) 662-9022 · Fax (309) 662-2091
Phone(309) 808-0122
Fax(309) 808-0552
Sole ProprietorYes
Enumeration DateOctober 2, 2006
Last NPPES UpdateMarch 12, 2013
✔ NPI 1588757579 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in IL · 036-068927
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
1537 FORT JESSE RD, Normal, IL 61761
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Other Identifiers 3

Medicare ID-Type Unspecified777460IL
Medicare UPINA53554
Medicaid0360689271IL

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KATHERINE WIDERBORG M.D., F.A.C.S., P.C.
Surgery
1537 FORT JESSE RD, SUITE A
NORMAL, IL 61761
McLean County (309) 808-0122
PREMIER MEDICAL GROUP, LLC
Surgery
1537 FORT JESSE RD, SUITE A
NORMAL, IL 61761
McLean County (309) 808-0122

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Katherine Widerborg's NPI number?

The NPI number for Katherine Widerborg is 1588757579. It was assigned to this individual provider in the NPPES registry on October 2, 2006.

Where is Katherine Widerborg located?

Katherine Widerborg practices at 1537 Fort Jesse Rd Suite A, Normal, IL 61761. The listed phone number is (309) 808-0122.

What is Katherine Widerborg's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

When was this NPI record last updated?

The NPPES record for Katherine Widerborg was last updated on March 12, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.