IndividualActive
Alexander Waldherr, DO
NPI 1457939704 · Sports Medicine (Family Medicine) Physician · Olney, IL
Provider details
- NPI number
- 1457939704
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- License
- 02007147B (IN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
504 Micah Dr
Olney, IL 62450-4720
Phone: (618) 388-3128
Fax: (618) 388-3127
Approximate (ZIP-level) locationGet directions
Mailing address
504 Micah Dr
Olney, IL 62450-4720
Registry dates
- Enumerated
- 2021-03-30
- Last updated
- 2025-10-22
- Certified
- 2025-10-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.