Provider Demographics
NPI:1154103059
Name:AMORSERV LLC
Entity type:Organization
Organization Name:AMORSERV LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:OTSE
Authorized Official - Middle Name:
Authorized Official - Last Name:AMORIGHOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-414-0435
Mailing Address - Street 1:2340 W TOUHY AVE STE B
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-3449
Mailing Address - Country:US
Mailing Address - Phone:312-414-0435
Mailing Address - Fax:
Practice Address - Street 1:139 SUE CT
Practice Address - Street 2:
Practice Address - City:CHICAGO HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60411-1023
Practice Address - Country:US
Practice Address - Phone:312-414-0435
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-17
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)