Provider Demographics
NPI:1033213020
Name:LITCHFIELD ONCOLOGY INSTITUTE LTD
Entity type:Organization
Organization Name:LITCHFIELD ONCOLOGY INSTITUTE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SALEEM
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHMOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:217-324-1100
Mailing Address - Street 1:PO BOX 483
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62056-0483
Mailing Address - Country:US
Mailing Address - Phone:217-324-1100
Mailing Address - Fax:217-324-1103
Practice Address - Street 1:1201 EAST UNION AVENUE
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:IL
Practice Address - Zip Code:62056
Practice Address - Country:US
Practice Address - Phone:217-324-1100
Practice Address - Fax:217-324-1103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0006832012OtherBLUE CROSS BLUE SHIELD
IL036091247Medicaid
920006658OtherRAILROAD MEDICARE
ILDN6303OtherRAILROAD MEDICARE PTAN