Individual
SHAWN W WYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
520 VALLEY VIEW DR, MOLINE, IL 61265-6194
(309) 762-3621
(309) 762-3690
Mailing address
520 VALLEY VIEW DR, MOLINE, IL 61265-6194
(309) 762-3621
(309) 762-3690
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036116081
IL
207X00000X
Orthopaedic Surgery Physician
37086
IA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
036116081
IL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
37086
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205990843
—
IA
01
—
55218
WELLMARK
IA
Enumeration date
12/20/2006
Last updated
03/05/2026
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