DR. ALEXANDER WALDHERR DO NPI 1457939704

NPI Information

  • NPI: 1457939704
  • Provider Name: DR. ALEXANDER WALDHERR, DO
  • Classification: Family Medicine - 207QS0010X
  • Specialization: Sports Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 504 MICAH DR
    OLNEY, IL
    ZIP 62450
  • Phone: (618) 388-3128

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NPI Details

DR. Alexander Waldherr, DO is a sports medicine family medicine in Olney, IL with 5 years of experience. The provider is a family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. DR. Alexander Waldherr, DO NPI is 1457939704. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MARIAN UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduation Year:2021

The provider's business location address is:

504 MICAH DR
OLNEY, IL
ZIP 62450-720
Phone: (618) 388-3128
Fax: (618) 388-3127

The NPI 1457939704 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/30/2021 and was last updated on 10/22/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine02007147BINDIANANo
2207Q00000XFamily Medicine036.170058ILLINOISNo
3207QS0010XFamily MedicineSports Medicine036.170058ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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