Individual
DR. HANI PETER NISSAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9229 KENTON AVE, SKOKIE, IL 60076-1526
(847) 414-4913
Mailing address
9229 KENTON AVE, SKOKIE, IL 60076-1526
(847) 414-4913
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
238.000141
IL
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
09/10/2012
Last updated
11/20/2022
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