# ANTHONY O AMIEWALAN MD, SC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** VIVIAN WOMENS CENTER, INC
- **Other names:** ANTHONY AMIEWALAN MD SC, ANTHONY O AMIEWALAN, VIVIAN WOMEN CENTER , INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1457367070
- **Legal business name:** VIVIAN WOMENS CENTER, INC
- **Authorized official:** MRS. GEORGIA M AMIEWALAN (BUSINESS MANAGER)
- **Authorized official phone:** (217) 422-0560

## Contact information

- **Practice address:** 2965 N MAIN ST STE A, DECATUR, IL 62526-4397
- **Practice address phone:** (217) 422-0560
- **Practice address fax:** (217) 422-0872
- **Mailing address:** 2965 N MAIN ST STE A, DECATUR, IL 62526-4397
- **Mailing address phone:** (217) 422-0560
- **Mailing address fax:** (217) 422-0872

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207VG0400X | Gynecology Physician | 036112019 | IL | — |
| 207VG0400X | Gynecology Physician | — | NULL | — |
| 207VG0400X | Gynecology Physician | — | — | — |
| 207VX0000X | Obstetrics Physician | 036112019 | IL | Yes |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 08/01/2006
- **Last updated:** 06/03/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 036112019 | — | IL |