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MR. TODD MICHAEL KUBON BA, MAMS, CCA
NPI 1164804142
Anaplastologist in Riverside, IL

Active since June 25, 2015
317 NUTTALL RD, RIVERSIDE, IL 60546(312) 978-1073 Get Directions Write a Review

NPPES record last updated: June 25, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Todd Michael Kubon Ba, Mams, Cca NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. TODD MICHAEL KUBON BA, MAMS, CCA (NPI 1164804142) is an individual anaplastologist provider in Riverside, Illinois and active in the NPI registry since June 2015.

NPPES Registry Identity

NPI1164804142
Entity TypeIndividualMale
Primary Taxonomy229N00000X
Provider Legal NameMR. TODD MICHAEL KUBONCredential: BA, MAMS, CCA
Location Address317 NUTTALL RDRiverside, IL 60546-1804
Mailing Address317 Nuttall RdRiverside, IL 60546-1804 · (312) 978-1073
Phone(312) 978-1073
Sole ProprietorYes
Enumeration DateJune 25, 2015
✔ NPI 1164804142 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnaplastologistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code229N00000X
Definition
An anaplastologist is a professional who creates prostheses for the face and body. Patients treated include those missing anatomy due to cancer, traumatic injury, or birth differences. Generally, there are no state licensing requirements for anaplastologists. Certification specific to anaplastology is provided through the Board for Certified Clinical Anaplastology (BCCA) with a credential title of Certified Clinical Anaplastologist (CCA).
317 NUTTALL RD, Riverside, IL 60546
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Other Identifiers 1

Other229N00000XIL · Wpc Code

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Todd Kubon's NPI number?

The NPI number for Todd Kubon is 1164804142. It was assigned to this individual provider in the NPPES registry on June 25, 2015.

Where is Todd Kubon located?

Todd Kubon practices at 317 Nuttall Rd, Riverside, IL 60546. The listed phone number is (312) 978-1073.

What is Todd Kubon's specialty?

The primary specialty registered for this NPI is Anaplastologist with taxonomy code 229N00000X.

When was this NPI record last updated?

The NPPES record for Todd Kubon was last updated on June 25, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.