Provider Demographics
NPI:1932695012
Name:TOOFAN MEDICAL HOLDINGS, LTD
Entity Type:Organization
Organization Name:TOOFAN MEDICAL HOLDINGS, LTD
Other - Org Name:LITCHFIELD URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:TOOFAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:217-994-9301
Mailing Address - Street 1:1001 AVENUE OF MID AMERICA STE 4
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62401-4634
Mailing Address - Country:US
Mailing Address - Phone:217-994-9301
Mailing Address - Fax:
Practice Address - Street 1:20 CORVETTE DR STE A
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:IL
Practice Address - Zip Code:62056-1038
Practice Address - Country:US
Practice Address - Phone:217-994-9301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOOFAN MEDICAL HOLDINGS, LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center