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115 E Pleasant St Taylorville IL 62568-1560 | |
| (217) 824-3757 | |
| (217) 824-9604 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 115 E Pleasant St, Taylorville, Illinois |
| Authorized Official Name and Position | Leslie Jackson (PRESIDENT) |
| Authorized Official Contact | 2178243757 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
115 E Pleasant St P O Box 318 Taylorville IL 62568-1560 Ph: (217) 824-3757 | 115 E Pleasant St Taylorville IL 62568-1560 Ph: (217) 824-3757 |
| NPI Number | 1386821502 |
|---|---|
| Provider Enumeration Date | 01/30/2008 |
| Last Update Date | 06/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386821502 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036072876 (Illinois) | Primary |
Toofan Medical Holdings, Ltd. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1510 W Springfield Rd Ste A, Taylorville, IL 62568 Phone: 217-824-8244 Fax: 217-994-9304 | |