EXCLUDEDPROVIDER
Individual Revocation

Nicole Annette Widergren

Rockford, IL 61109

Public HHS-OIG LEIE exclusion record

According to the HHS-OIG List of Excluded Individuals/Entities (LEIE), Nicole Annette Widergren of Rockford, IL is currently excluded from participation in federally funded health care programs due to license revocation, suspension, or surrender, as of July 18, 2019.

Status
Currently listed by HHS-OIG
Record type
Individual
Location
Rockford, IL 61109
Exclusion date
July 18, 2019
Exclusion type
License revocation, suspension, or surrender (1128b4)
Source dataset
May 2026

Record summary

Nicole Annette Widergren appears in the HHS-OIG List of Excluded Individuals/Entities (LEIE) public dataset as an individual record associated with Rockford, Illinois. The latest imported LEIE dataset lists this record as currently excluded from participation in federally funded health care programs. The exclusion date shown in the source record is July 18, 2019, and the exclusion type is 1128b4, identified by HHS-OIG as license revocation, suspension, or surrender.

Source record

SourceHHS-OIG LEIE (public dataset)
Record typeIndividual
Current statusCurrently listed by HHS-OIG
Exclusion dateJuly 18, 2019
Exclusion typeLicense revocation, suspension, or surrender (1128b4)
Source dataset dateMay 2026

What this exclusion type means

HHS-OIG identifies exclusion type 1128b4 as “License revocation, suspension, or surrender.” License revocation, suspension, or surrender (permissive exclusion).

This exclusion type is a statutory category used by HHS-OIG in the LEIE dataset. The category describes the legal authority associated with the exclusion record, not a separate investigation or additional reporting by Excluded Provider.

Location and provider classification

This LEIE record is associated with Rockford, IL 61109. The listed provider category is Individual - Licensed Health Care Service Provider. The listed specialty is Nurse / Nurses Aide.

Other excluded providers in Rockford, IL

Other individuals and entities currently listed in the HHS-OIG LEIE public dataset with a Rockford, IL address.

Forlicia M Williams Individual Program Crime
Rockford, IL · Conviction of program-related crimes · Excluded Dec 2024
Jessica Herbert Individual Program Crime
Rockford, IL · Conviction of program-related crimes · Excluded Jan 2024
Marcus Newble Individual Program Crime
Rockford, IL · Conviction of program-related crimes · Excluded Feb 2022
Shannon Howard Individual Program Crime
Rockford, IL · Conviction of program-related crimes · Excluded Nov 2021
Sheila Pickney Individual Suspension
Rockford, IL · Exclusion or suspension under a federal or state health care program · Excluded Dec 2020
Martha M Ingram Individual Program Crime
Rockford, IL · Conviction of program-related crimes · Excluded Aug 2019
Kelly Jr Booker Individual Program Crime
Rockford, IL · Conviction of program-related crimes · Excluded Jul 2019
Jennifer Windrow Individual Revocation
Rockford, IL · License revocation, suspension, or surrender · Excluded May 2019

See all 68 excluded providers in Rockford →

How to verify this record

This page is a public-record summary and should be treated as a possible LEIE match, not final identity verification. To verify the record, use the official HHS-OIG LEIE search and compare available identifying information through the official process. Name, location, provider category, specialty, exclusion date, and NPI should be treated as matching clues rather than final proof of identity.

What this page does not include

This page summarizes the HHS-OIG LEIE public dataset only. It does not search state Medicaid exclusion lists, state licensing-board actions, court records, malpractice records, employment history, civil lawsuits, or non-public investigations.

Verify with HHS-OIG Remove / correct this record

Related

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