Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Hani Peter Nissan

Individual provider Surgical Physician Assistant · NPI 1902155633

Dr. Hani Peter Nissan is a Surgical Physician Assistant in Skokie, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2012
Specialties on file
2

Practice location Address checks out

9229 Kenton Ave
Skokie, IL 60076-1526
Phone: (847) 414-4913
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X
Surgical Assistant Taxonomy 246ZC0007X · Licence 238.000141 (IL)

Record details

NPI number1902155633
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedSeptember 10, 2012
Last updated in NPPESNovember 20, 2022
Certification dateDecember 24, 2020
Mailing address9229 Kenton Ave, Skokie, IL 60076-1526

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