ANTHONY O AMIEWALAN MD, SC
NPI 1053543215
Legal Medicine in Decatur, IL

Q: What is Anthony O Amiewalan MD, Sc's NPI number?

The NPI number for Anthony O Amiewalan MD, Sc is 1053543215. It was assigned to this organization in the NPPES registry on August 20, 2009. The provider is doing business as Anthony O Amiewalan MD Sc.

Q: What is Anthony O Amiewalan MD, Sc's specialty?

The primary specialty registered for this NPI is Legal Medicine with taxonomy code 173000000X.

Active since August 20, 2009

2965 N MAIN ST STE A, DECATUR, IL 62526(217) 422-0560(217) 422-0872 Get Directions Write a Review

NPPES record last updated: March 27, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Anthony O Amiewalan Md, Sc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANTHONY O AMIEWALAN MD, SC (NPI 1053543215), doing business as Anthony O Amiewalan Md Sc, is a healthcare organization registered as a legal medicine in Decatur, Illinois and active in the NPI registry since August 2009. The organization lists Anthony O Amiewalan, Doctor, as its authorized official.

NPPES Registry Identity

NPI1053543215

Entity TypeOrganization

Primary Taxonomy173000000X

Legal Business NameANTHONY O AMIEWALAN MD, SC

Location Address2965 N MAIN ST STE ADecatur, IL 62526-4397

Mailing Address2665 North Main Street, Suite ADecatur, IL 62526-3803 · (217) 422-0560 · Fax (217) 422-0872

Phone(217) 422-0560

Fax(217) 422-0872

Organization SubpartNo

Authorized OfficialAnthony O AmiewalanDoctor · (217) 422-0560

Enumeration DateAugust 20, 2009

Last NPPES UpdateMarch 27, 2025

NPPES CertifiedMarch 24, 2025

✔ NPI 1053543215 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyLegal MedicineOther Service Providers

Taxonomy Code173000000X

License✔ Licensed in IL · 036112019

Definition

The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections.

Also ListedClinic/CenterTaxonomy 261Q00000X

Also ListedClinic/Center · Health ServiceTaxonomy 261QH0100X

2965 N MAIN ST STE A, Decatur, IL 62526

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Other Names 1

Doing Business AsAnthony O Amiewalan Md Sc

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Anthony O Amiewalan Md, Sc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Anthony O Amiewalan MD, Sc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Anthony Amiewalan, MD FACOG

Obstetrics/Gynecology

NPI 1669486668

1750 EAST LAKE SHORE DR SUITE 320
Decatur, IL 62521

(217) 422-0560

✔ PECOS✔ Accepts Medicare3.6 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Anthony O Amiewalan MD, Sc's NPI number?

The NPI number for Anthony O Amiewalan MD, Sc is 1053543215. It was assigned to this organization in the NPPES registry on August 20, 2009. The provider is doing business as Anthony O Amiewalan MD Sc.

Where is Anthony O Amiewalan MD, Sc located?

Anthony O Amiewalan MD, Sc is located at 2965 N Main St Ste A, Decatur, IL 62526. The listed phone number is (217) 422-0560.

What is Anthony O Amiewalan MD, Sc's specialty?

The primary specialty registered for this NPI is Legal Medicine with taxonomy code 173000000X.

Is Anthony O Amiewalan MD, Sc enrolled in Medicare?

Yes. Anthony O Amiewalan MD, Sc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Anthony O Amiewalan MD, Sc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Obstetrics/Gynecology) reassigns their Medicare billing to Anthony O Amiewalan MD, Sc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Anthony O Amiewalan MD, Sc was last updated on March 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.