Organization
DR. KATHERINE WIDERBORG M.D., F.A.C.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHERINE WIDERBORG M.D. (OWNER)
(309) 212-2002
Entity
Organization
Contact information
Practice address
1537 FORT JESSE RD, SUITE A, NORMAL, IL 61761-6192
(309) 808-0122
(309) 808-1187
Mailing address
1537 FORT JESSE RD, SUITE A, NORMAL, IL 61761-6192
(309) 808-0122
(309) 808-1187
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036-068927
IL
Other
Enumeration date
08/04/2009
Last updated
09/21/2009
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