Wynn, Shawn W

Wynn, Shawn W is an individual health care provider with primary practice located at 520 Valley View Dr , Moline IL 61265-6194. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Wynn, Shawn W can be contacted via phone (309) 762-3621.

Contact Information

Primary practice address
520 Valley View Dr Moline IL 61265-6194
Phone: (309) 762-3621
Fax: (309) 762-3690
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 036116081 Illinois
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 37086 Iowa
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 036116081 Illinois
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 37086 Iowa

Profile Details

NPI number 1205990843
LBN Legal business name Wynn, Shawn W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 20th, 2006
Last updated Mar 18th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1205990843 NPPES
Iowa Other 55218 WELLMARK
Iowa MEDICAID 1205990843 WELLMARK

Popular Providers