OrganizationActive
Premier Medical Group, LLC
NPI 1720377690 · Surgery Physician · Normal, IL
Premier Medical Group, LLC is a Surgery Physician organization in Normal, IL (NPI 1720377690).
Provider details
- NPI number
- 1720377690
- Entity type
- Organization
- Primary specialty
- Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- John Hesse, Executive Administrator(309) 662-6200
- License
- 36-068927 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(82/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1537 Fort Jesse Rd
Suite a
Normal, IL 61761-6192
Phone: (309) 808-0122
Fax: (309) 808-0522
Street-level locationGet directions
Mailing address
1537 Fort Jesse Rd
Normal, IL 61761-6192
Other names (DBA / former)
- Doing business as
- Katherine Widerborg, M.D.
Registry dates
- Enumerated
- 2011-03-31
- Last updated
- 2011-03-31
Frequently asked questions
- What is Premier Medical Group, LLC's NPI number?
- Premier Medical Group, LLC's National Provider Identifier (NPI) is 1720377690, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Premier Medical Group, LLC?
- Premier Medical Group, LLC is classified in the NPPES registry as Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Premier Medical Group, LLC located?
- Premier Medical Group, LLC's practice location on file with NPPES is 1537 Fort Jesse Rd, Normal, IL 61761-6192.
- What is Premier Medical Group, LLC's phone number?
- The practice phone number listed in the NPPES registry for Premier Medical Group, LLC is (309) 808-0122.
- Who is the authorized official for Premier Medical Group, LLC?
- The authorized official listed on Premier Medical Group, LLC's NPPES record is John Hesse, Executive Administrator. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Premier Medical Group, LLC's NPI active?
- Yes — Premier Medical Group, LLC's NPI (1720377690) is active in the NPPES registry as of the last update on 2011-03-31.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.