Healthcare Provider Details

I. General information

NPI: 1407452923
Provider Name (Legal Business Name): HUDA AMORAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2020
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1165 N CLARK ST
CHICAGO IL
60610-2702
US

IV. Provider business mailing address

5961 N LINCOLN AVE
CHICAGO IL
60659-3758
US

V. Phone/Fax

Practice location:
  • Phone: 312-280-8140
  • Fax:
Mailing address:
  • Phone: 312-702-3923
  • Fax: 773-942-6036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209022073
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209022073
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: