Dr. Todd Mathew Anderson
Oral and Maxillofacial Surgeon Oral & Maxillofacial Surgeon
1675 Bethany Rd Suite A
Sycamore
, Illinois 60178
Dr. Todd Mathew Anderson
Oral and Maxillofacial Surgeon Oral & Maxillofacial Surgeon
1675 Bethany Rd Suite A
Sycamore
, Illinois 60178
(815) 895-0505
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
- Oral & Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Dr. Todd Mathew Anderson
- 1675 Bethany Rd Suite A
- Sycamore, IL
- Zip : 60178
- Fax : (815) 895-0505
- Phone : (815) 895-3000
Second Address
- Dr. Todd Mathew Anderson
- 1675 Bethany Rd Suite A
- Sycamore, IL
- Zip : 60178
- Fax : (815) 895-0505
- Phone : (815) 895-3000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 1223S0112X | Oral and Maxillofacial Surgeon | 021001563 | IL |
| Y | 204E00000X | Oral & Maxillofacial Surgeon | 19022431 | IL |
National Provider Identifier
| NPI | 1497867626 |
|---|---|
| Provider Name | Dr. Todd Mathew Anderson |
| First Address | Sycamore, IL 60178 |
| Second Address | Sycamore, IL 60178 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 01/09/2006 |
| Last Update Date | 19/07/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| U27021 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.