KENNETH RICHARD NISSIM

ROCKFORD, IL
NPI1447246392
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck
(Licence: IL  036170811)
Additional Taxonomies207YS0012X Otolaryngology, Sleep Medicine
(Licence: FL  ME85561)
207Y00000X Otolaryngology
(Licence: FL  ME85561)
Enumeration Date2005-09-26
Last Update Date2024-12-11
Business Address
KENNETH RICHARD NISSIM M.D.
1253 N ALPINE RD
ROCKFORD, IL 61107-2201
Phone number: 779-696-9201
Mailing Address
KENNETH RICHARD NISSIM M.D.
1120 NW 14TH ST 5TH FLOOR
MIAMI, FL 33136-2107
Phone number: 305-243-3564