Active NPI 1164804142 Individual Practitioner Male Practitioner

Todd Michael Kubon , BA, MAMS, CCA

Anaplastologist • Riverside, IL

Professional Overview & Biography Verified Profile Summary

Todd Kubon, BA, MAMS, CCA is a registered healthcare professional specializing in Anaplastologist in Riverside, IL. Practice services are available at 317 NUTTALL RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

317 Nuttall Rd

Riverside, IL 605461804

Telephone 3129781073

Specialty Benchmarks & Practice Insights

Comparative analytics for Anaplastologist in Riverside, IL

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 10.2 Yrs

Regional Practice Density

1 Specialists

Practicing in Riverside, IL (5 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Anaplastologist Primary Specialty

NUCC Taxonomy Code: 229N00000X

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).

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Wpc Code

229N00000X (IL)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active June 25, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location June 25, 2015

Registered at 317 NUTTALL RD, RIVERSIDE, IL 605461804 (Tel: 3129781073)

📍

Updated Business Mailing Address June 25, 2015

Registered at 317 NUTTALL RD, RIVERSIDE, IL 605461804 (Tel: 3129781073)

👤

Provider Name / Credentials Updated June 25, 2015

Recorded as TODD KUBON, BA, MAMS, CCA

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 25, 2015

Anaplastologist

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Initial NPI Registration & Enumeration June 25, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1164804142

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: June 25, 2015

Last Update: June 25, 2015

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

317 Nuttall Rd

Riverside, IL 605461804

Phone: 3129781073

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.