MEDICARE: DIANA T WIDICUS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	36062017	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8415046	OTHER	IL	BCBS

General Provider Information

NPI Number	:	1851471072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA T WIDICUS MD

Provider Business Mailing Address
First Line	:	1836 SOUTH MACARTHUR BLVD
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62704
Country	:	US
Telephone Number	:	217-789-1403
Fax Number	:	217-789-1825

Provider Business Practice Location Address
First Line	:	300 SATTLEY ST
Second Line	:
City	:	ROCHESTER
State	:	IL
Zip	:	62563-9241
Country	:	US
Telephone Number	:	217-789-3630
Fax Number	:	217-498-6812

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	12/30/2021

Similar Medicare Providers

1225074495 — MARY ELY N.P.
Practice Location Address:

300 SATTLEY ST
ROCHESTER, IL
62563-9241

Practice Phone: 217-789-3630
Practice Fax:

1609967694 — DR. ELLEN FISCHER DDS
Practice Location Address:

318 SATTLEY ST
ROCHESTER, IL
62563-9241

Practice Phone: 217-498-3622
Practice Fax:

1457646028 — ERICA LANE CONRAD M.D.
Practice Location Address:

300 SATTLEY ST
ROCHESTER, IL
62563-9241

Practice Phone: 217-789-3630
Practice Fax: 217-498-6812

1912542051 — STEPHANIE A OLSEN APRN
Practice Location Address:

300 SATTLEY ST
ROCHESTER, IL
62563-9241

Practice Phone: 217-789-3630
Practice Fax:

1598763880 — STEVEN JOSEPH LEWIS MD
Practice Location Address:

45 WOODLAND TRL
ROCHESTER, IL
62563-9553

Practice Phone: 217-836-0766
Practice Fax:

1699743823 — DR. NATHAN R CORBIN D.C.
Practice Location Address:

207 S WALNUT ST
ROCHESTER, IL
62563-7501

Practice Phone: 585-889-3280
Practice Fax: 585-889-7759

Directions to “ DIANA T WIDICUS MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.