ANTHONY O AMIEWALAN MD SC NPI 1457367070

NPI Information

  • NPI: 1457367070
  • Provider Name: ANTHONY O AMIEWALAN MD, SC
  • Classification: Obstetrics & Gynecology - 207VX0000X
  • Specialization: Obstetrics
  • Entity Type: Organization
  • :
  • Address: 2965 N MAIN ST STE A
    DECATUR, IL
    ZIP 62526
  • Phone: (217) 422-0560

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NPI Details

ANTHONY O AMIEWALAN MD, SC is an obstetrics obstetrics gynecology in Decatur, IL. The provider is a physician who specializes in diagnosis, treatment, and management of patients with obstetric conditions. Source: National Uniform Claim Committee ANTHONY O AMIEWALAN MD, SC NPI is 1457367070. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

2965 N MAIN ST STE A
DECATUR, IL
ZIP 62526-397
Phone: (217) 422-0560
Fax: (217) 422-0872

The provider's authorized official is Georgia M Amiewalan .
The authorized official title is Business Manager and has the following contact phone number (217) 422-0560.

The enumeration date for this NPI number is 8/1/2006 and was last updated on 3/27/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207VG0400XObstetrics & GynecologyGynecology036112019ILLINOISNo
2207VG0400XObstetrics & GynecologyGynecologyNo
3207VX0000XObstetrics & GynecologyObstetrics036112019ILLINOISYes
4261Q00000XClinic/CenterNo
5261QP2300XClinic/CenterPrimary CareNo
6261QR1300XClinic/CenterRural HealthNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1036112019MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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