NPI 1164804142

Todd Michael Kubon, BAMAMSCCA

Practitioner Anaplastologist Riverside, IL

Practice location

Address: 317 Nuttall Rd, Riverside, IL 60546-1804
Phone: (312) 978-1073

Registered specialties

Anaplastologist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 229N00000X

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Registry record

NPI: 1164804142
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Jun 2015
Record last updated: 25 Jun 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.