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NPI Profile for KENNETH R NISSIM in ROCKFORD, IL.
An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Plastic Surgery within the Head & Neck |
207YX0007X | 04 | Physician/Otolaryngology | |
Otolaryngology |
207Y00000X | 04 | Physician/Otolaryngology | |
Sleep Medicine |
207YS0012X | 04 | Physician/Otolaryngology |
| NPI Number | 1447246392 |
|
| Status | Active | |
| Credentials | MD | |
| Entity | Individual | |
| Enumeration date | 09/26/2005 | |
| Last updated | 12/11/2024 - More than a year ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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| Hospital affiliation(s) | Not Available |
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KENNETH R NISSIM
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KENNETH R NISSIM, MD