Dr. Katherine Widerborg M.d., F.a.c.s., P.c.

NPI #1699906966 in Normal, Illinois

Provider Information

NPI Number: 1699906966
Entity Type: Organization
Organization Name: Dr. Katherine Widerborg M.d., F.a.c.s., P.c.
Primary Specialty: Surgery
Enumeration Date: Aug 4, 2009
Last Updated: Sep 21, 2009

Practice Location

Address: 1537 FORT JESSE RD
Address 2: SUITE A
City: Normal
State: Illinois
ZIP Code: 61761-6192
Phone: (309) 808-0122

Authorized Official

Name: DR. KATHERINE WIDERBORG, M.D.
Title: OWNER
Phone: (309) 212-2002

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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