NPI 1053543215

Anthony O Amiewalan MD, Sc

Organisation Legal Medicine Decatur, IL

Practice location

Address: 2965 N Main St STE a, Decatur, IL 62526-4397
Phone: (217) 422-0560
Fax: (217) 422-0872
Mailing address: 2665 North Main Street Suite a, Decatur, IL 62526-3803

Authorised official

Name: Anthony O Amiewalan
Title: Doctor
Phone: (217) 422-0560

Registered specialties (3)

Legal Medicine Primary

Other Service Providers Taxonomy 173000000X Licence 036112019 (IL)

Other Legal Medicine providers in Illinois →

Clinic/Center

Ambulatory Health Care Facilities Taxonomy 261Q00000X

Other Clinic/Center providers in Illinois →

Health Service Clinic/Center

Ambulatory Health Care Facilities Taxonomy 261QH0100X

Registry record

NPI: 1053543215
Entity type: Organization
NPI issued: 20 Aug 2009
Record last updated: 27 Mar 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.