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

Active since August 20, 2009CLIA 36D0866197 · Microscopy
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: August 16, 2026.

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 holds a CLIA Microscopy certificate valid through August 31, 2026 and 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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 36D0866197

Anthony Amiewalan MD Sc · Decatur, IL
Active · expires Aug 31, 2026
CLIA Number36D0866197
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorAnthony O. Amiewalan MD
Laboratory Phone(217) 422-0560
Laboratory LocationAnthony Amiewalan MD Sc1750 E Lake Shore Drive Suite 320, Decatur, IL 62521
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANTHONY O AMIEWALAN MD, SC
Obstetrics & Gynecology (Obstetrics)
2965 N MAIN ST STE A
DECATUR, IL 62526
Macon County (217) 422-0560

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.

Does Anthony O Amiewalan MD, Sc hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 36D0866197) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

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 16 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.