Provider Demographics
NPI:1063176733
Name:TOOFAN MEDICAL HOLDINGS, LTD
Entity type:Organization
Organization Name:TOOFAN MEDICAL HOLDINGS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
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 1:1325 KOESTER DR
Mailing Address - Street 2:
Mailing Address - City:FORSYTH
Mailing Address - State:IL
Mailing Address - Zip Code:62535-9625
Mailing Address - Country:US
Mailing Address - Phone:217-330-6868
Mailing Address - Fax:213-330-6966
Practice Address - Street 1:1325 KOESTER DR
Practice Address - Street 2:
Practice Address - City:FORSYTH
Practice Address - State:IL
Practice Address - Zip Code:62535-9625
Practice Address - Country:US
Practice Address - Phone:217-330-6868
Practice Address - Fax:213-330-6966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-28
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care