Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Premier Medical Group, LLC

Organization Surgery Physician · NPI 1720377690

Premier Medical Group, LLC is a Surgery Physician in Normal, Illinois. Licensed in Illinois. Registered with an NPI since 2011.

Licensed in
IL
In the registry since
2011
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1537 Fort Jesse Rd Ste A
Normal, IL 61761-6192
Phone: (309) 808-0122
Fax: (309) 808-0522
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 36-068927 (IL)

Record details

NPI number1720377690
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Hesse — Executive Administrator · (309) 662-6200
Other names Katherine Widerborg, M.D.
NPI enumeratedMarch 31, 2011
Last updated in NPPESMarch 31, 2011
Mailing address1537 Fort Jesse Rd, Suite A, Normal, IL 61761-6192

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