Active NPI 1205990843 Individual Practitioner Male Practitioner

Dr. Shawn W Wynn , MD

Orthopaedic Surgery • Moline, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Shawn Wynn, MD is a certified Orthopaedic Surgery practicing in Moline, IL. With approximately 25 years of clinical experience since graduating from Rush Medical College Of Rush University in 2001, Dr. Wynn delivers high-quality medical care to the local community at 520 VALLEY VIEW DR.

Dr. Wynn is affiliated with Ora Orthopedics Pc and accepts Medicare assignment.

Frequently performed procedures and clinical services include injection, triamcinolone acetonide, not otherwise specified, 10 mg, hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg, injection, gadoterate meglumine, 0.1 ml. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

520 Valley View Dr

Moline, IL 612656194

Telephone 3097623621

Fax 3097623690

Associated Practice Facility / Clinic

🏢 Ora Orthopedics Pc Facility NPI 1962481861

Medicare Profile & Education

Medical School

Rush Medical College Of Rush University

Graduation Year

2001

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Orthopaedic Surgery in Moline, IL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

25 Yrs +0.4 yrs vs City Avg

City Avg: 24.6 Yrs

State Avg: 27.0 Yrs

Regional Practice Density

12 Specialists

Practicing in Moline, IL (1064 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

79.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wynn (25 Years) 25 Yrs

Moline Specialty Average (24.6 Years) 24.6 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	967	124	$6.00	$0.97
J7325 Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg	912	12	$25.00	$8.83
A9575 Injection, gadoterate meglumine, 0.1 ml	320	17	$0.52	$0.12
20610 Aspiration and/or injection of fluid from large joint	209	138	$512.18	$71.02
99213 Established patient office or other outpatient visit, typically 15 minutes	170	123	$268.00	$85.47
73564 X-ray of knee, 4 or more views	121	91	$150.00	$43.34
73562 X-ray of knee, 3 views	121	49	$128.17	$37.10
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	117	103	$379.00	$121.74
73030 X-ray of shoulder, minimum of 2 views	100	56	$121.00	$32.13
73502 X-ray of hip, 2-3 views	87	53	$139.75	$43.22
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	67	57	$168.00	$53.11
73110 X-ray of wrist, minimum of 3 views	30	13	$129.00	$36.08
27447 Replacement of knee joint, both sides of knee	26	23	$6409.00	$1241.58
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	24	24	$544.00	$156.16
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	18	18	$357.00	$107.04
73222 Mri scan of arm joint with contrast	17	16	$1531.06	$224.47
73130 X-ray of hand, minimum of 3 views	14	11	$111.00	$34.13
72100 X-ray of lower and sacral spine, 2-3 views	14	14	$123.00	$36.75

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7325 Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg	2,160	30	$24.98	$9.29
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	999	117	$6.00	$1.07
A9575 Injection, gadoterate meglumine, 0.1 ml	430	15	$0.64	$0.13
20610 Aspiration and/or injection of fluid from large joint	227	129	$509.09	$69.47
99213 Established patient office or other outpatient visit, typically 15 minutes	171	132	$265.49	$85.72
73562 X-ray of knee, 3 views	131	60	$128.01	$37.59
73564 X-ray of knee, 4 or more views	119	95	$149.71	$43.60
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	93	76	$166.71	$53.52
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	90	80	$378.04	$121.91
73502 X-ray of hip, 2-3 views	90	56	$140.44	$43.81
73030 X-ray of shoulder, minimum of 2 views	88	58	$120.18	$32.00
27447 Replacement of knee joint, both sides of knee	29	28	$6398.48	$1238.65
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	26	26	$357.00	$108.47
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	23	23	$544.00	$161.02
73110 X-ray of wrist, minimum of 3 views	21	12	$129.00	$38.23
73130 X-ray of hand, minimum of 3 views	17	11	$111.00	$34.52
27130 Replacement of thigh bone and hip joint with prosthesis	14	14	$6854.50	$1266.33
73222 Mri scan of arm joint with contrast	13	13	$1539.38	$222.49
73721 Mri scan of leg joint without contrast	11	11	$1121.45	$145.99

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7325 Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg	1,824	22	$24.00	$10.06
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	893	108	$6.00	$1.15
20610 Aspiration and/or injection of fluid from large joint	239	137	$505.00	$73.27
99213 Established patient office or other outpatient visit, typically 15 minutes	238	179	$229.00	$87.46
73564 X-ray of knee, 4 or more views	135	98	$142.26	$43.53
73030 X-ray of shoulder, minimum of 2 views	133	76	$106.71	$32.07
73502 X-ray of hip, 2-3 views	128	92	$114.69	$43.77
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	125	110	$336.00	$121.80
73562 X-ray of knee, 3 views	120	56	$121.57	$37.67
A9575 Injection, gadoterate meglumine, 0.1 ml	120	12	$0.27	$0.14
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	88	77	$138.00	$54.50
J1040 Injection, methylprednisolone acetate, 80 mg	53	37	$20.00	$11.22
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	41	41	$518.00	$163.17
73610 X-ray of ankle, minimum of 3 views	37	17	$106.95	$34.37
72110 X-ray of lower and sacral spine, minimum of 4 views	32	32	$159.00	$47.62
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	31	31	$340.00	$109.09
27447 Replacement of knee joint, both sides of knee	21	21	$6104.00	$1238.94
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	20	20	$220.00	$69.49
73721 Mri scan of leg joint without contrast	16	15	$969.00	$136.96
73130 X-ray of hand, minimum of 3 views	13	12	$100.31	$32.82
27245 Treatment of broken neck of thigh bone with bone implant	11	11	$4885.00	$1222.97

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J1040 Injection, methylprednisolone acetate, 80 mg	238	125	$20.00	$10.65
20610 Aspiration and/or injection of fluid from large joint	228	146	$441.16	$71.00
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	193	157	$336.00	$126.87
99213 Established patient office or other outpatient visit, typically 15 minutes	191	144	$229.00	$89.05
73502 X-ray of hip, 2-3 views	169	88	$115.50	$43.94
73564 X-ray of knee, 4 or more views	131	103	$143.00	$43.50
A9575 Injection, gadoterate meglumine, 0.1 ml	130	13	$0.27	$0.16
73030 X-ray of shoulder, minimum of 2 views	119	78	$108.36	$32.36
73562 X-ray of knee, 3 views	99	49	$123.00	$38.29
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	90	76	$138.00	$54.49
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	51	51	$518.00	$165.13
72110 X-ray of lower and sacral spine, minimum of 4 views	41	41	$159.00	$48.08
27130 Replacement of thigh bone and hip joint with prosthesis	27	26	$6510.00	$1303.00
27447 Replacement of knee joint, both sides of knee	27	26	$6104.00	$1289.55
73610 X-ray of ankle, minimum of 3 views	26	11	$103.15	$32.75
73110 X-ray of wrist, minimum of 3 views	26	15	$123.00	$38.26
J7326 Hyaluronan or derivative, gel-one, for intra-articular injection, per dose	22	15	$1250.00	$1219.00
73080 X-ray of elbow, minimum of 3 views	21	13	$109.00	$28.91
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	16	16	$220.00	$70.76
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	14	14	$318.00	$101.65
73222 Mri scan of arm joint with contrast	13	13	$1309.00	$260.50
73130 X-ray of hand, minimum of 3 views	13	12	$106.00	$34.44
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	12	12	$340.00	$110.07

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7325 Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg	1,488	22	$24.00	$10.54
A9575 Injection, gadoterate meglumine, 0.1 ml	660	14	$0.27	$0.18
99213 Established patient office or other outpatient visit, typically 15 minutes	292	192	$229.00	$73.25
J1040 Injection, methylprednisolone acetate, 80 mg	225	116	$20.00	$11.56
20610 Aspiration and/or injection of fluid from large joint	222	144	$294.98	$69.44
73562 X-ray of knee, 3 views	179	63	$120.99	$36.75
73502 X-ray of hip, 2-3 views	159	82	$110.36	$41.01
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	129	121	$336.00	$105.87
73564 X-ray of knee, 4 or more views	105	85	$139.80	$40.47
73030 X-ray of shoulder, minimum of 2 views	99	70	$106.70	$31.03
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	92	92	$340.00	$105.03
72110 X-ray of lower and sacral spine, minimum of 4 views	34	34	$151.50	$44.17
27447 Replacement of knee joint, both sides of knee	29	27	$6314.52	$1396.26
27130 Replacement of thigh bone and hip joint with prosthesis	20	18	$6510.00	$1410.07
73110 X-ray of wrist, minimum of 3 views	18	12	$123.00	$37.05
73552 X-ray of thigh bone, minimum 2 views	17	12	$91.00	$33.00
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	14	14	$318.00	$105.41
73130 X-ray of hand, minimum of 3 views	13	12	$106.00	$33.32
73222 Mri scan of arm joint with contrast	11	11	$1428.00	$289.73

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7325 Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg	1,488	23	$24.00	$11.27
A9575 Injection, gadoterate meglumine, 0.1 ml	460	13	$0.27	$0.21
99213 Established patient office or other outpatient visit, typically 15 minutes	308	194	$229.00	$72.49
73562 X-ray of knee, 3 views	209	83	$112.91	$32.66
J1040 Injection, methylprednisolone acetate, 80 mg	209	131	$20.00	$12.08
20610 Aspiration and/or injection of fluid from large joint	207	148	$288.65	$65.94
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	178	161	$336.00	$105.63
73564 X-ray of knee, 4 or more views	165	131	$138.93	$38.39
73502 X-ray of hip, 2-3 views	151	77	$110.65	$38.91
73030 X-ray of shoulder, minimum of 2 views	130	84	$106.21	$27.99
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	89	89	$340.00	$106.31
27447 Replacement of knee joint, both sides of knee	45	43	$6239.67	$1404.42
73110 X-ray of wrist, minimum of 3 views	26	14	$120.23	$34.02
73630 X-ray of foot, minimum of 3 views	23	17	$97.61	$28.27
72110 X-ray of lower and sacral spine, minimum of 4 views	23	23	$150.65	$45.99
73130 X-ray of hand, minimum of 3 views	21	17	$101.43	$30.49
73721 Mri scan of leg joint without contrast	16	16	$969.00	$148.24
27130 Replacement of thigh bone and hip joint with prosthesis	16	15	$6200.00	$1392.29
99221 Initial hospital inpatient care per day, typically 30 minutes	12	11	$312.00	$95.42

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7325 Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg	1,680	23	$24.00	$11.76
97110 Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes	1,181	401	$65.00	$25.45
97530 Therapy procedure using functional activities	646	280	$72.00	$38.00
97140 Therapy procedure using manual technique, each 15 minutes	406	224	$61.00	$22.38
99213 Established patient office or other outpatient visit, typically 15 minutes	283	201	$229.00	$73.85
J1040 Injection, methylprednisolone acetate, 80 mg	227	137	$20.00	$12.97
20610 Aspiration and/or injection of fluid from large joint	223	151	$301.16	$69.52
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	209	186	$336.00	$109.16
73564 X-ray of knee, 4 or more views	198	154	$137.70	$37.60
73562 X-ray of knee, 3 views	188	77	$115.23	$33.12
97112 Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes	148	102	$68.00	$31.64
73502 X-ray of hip, 2-3 views	140	67	$108.63	$38.19
73030 X-ray of shoulder, minimum of 2 views	136	70	$101.96	$26.95
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	110	110	$340.00	$109.49
73110 X-ray of wrist, minimum of 3 views	54	24	$108.33	$30.81
97162 Evaluation for physical therapy, typically 30 minutes	44	43	$153.00	$85.29
73610 X-ray of ankle, minimum of 3 views	40	21	$99.67	$28.55
27447 Replacement of knee joint, both sides of knee	38	38	$6104.00	$1439.88
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	31	30	$138.00	$44.14
73130 X-ray of hand, minimum of 3 views	26	18	$96.15	$28.63
97116 Walking training to 1 or more areas, each 15 minutes	26	23	$62.00	$24.11
73080 X-ray of elbow, minimum of 3 views	21	13	$99.57	$28.51
73721 Mri scan of leg joint without contrast	18	18	$1076.67	$182.34
72110 X-ray of lower and sacral spine, minimum of 4 views	18	18	$135.00	$40.19
27130 Replacement of thigh bone and hip joint with prosthesis	17	17	$6200.00	$1447.86
99221 Initial hospital inpatient care per day, typically 30 minutes	15	15	$312.00	$106.22
97035 Application of ultrasound, each 15 minutes	15	11	$30.00	$11.00
97161 Evaluation of physical therapy, typically 20 minutes	14	14	$133.00	$84.82
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	13	13	$424.00	$142.79

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7325 Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg	1,536	20	$24.00	$12.47
97110 Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes	526	255	$65.00	$24.65
97530 Therapy procedure using functional activities	327	204	$72.00	$30.99
99213 Established patient office or other outpatient visit, typically 15 minutes	303	198	$229.00	$69.75
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	257	205	$336.00	$102.97
20610 Aspiration and/or injection of fluid from large joint	251	161	$299.94	$66.19
97140 Therapy procedure using manual technique, each 15 minutes	177	130	$61.00	$21.82
73562 X-ray of knee, 3 views	157	64	$114.66	$31.17
73564 X-ray of knee, 4 or more views	155	121	$136.56	$35.33
J1030 Injection, methylprednisolone acetate, 40 mg	137	103	$10.00	$5.59
73502 X-ray of hip, 2-3 views	131	81	$110.56	$36.75
73030 X-ray of shoulder, minimum of 2 views	128	88	$105.83	$26.16
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	113	113	$340.00	$103.71
J1040 Injection, methylprednisolone acetate, 80 mg	96	65	$20.00	$11.64
97112 Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes	48	34	$68.00	$26.67
73610 X-ray of ankle, minimum of 3 views	45	25	$95.36	$25.84
27447 Replacement of knee joint, both sides of knee	27	27	$6104.00	$1365.37
73721 Mri scan of leg joint without contrast	27	27	$1076.67	$170.77
73630 X-ray of foot, minimum of 3 views	26	14	$85.12	$22.34
73130 X-ray of hand, minimum of 3 views	24	21	$98.00	$26.59
72100 X-ray of lower and sacral spine, 2-3 views	23	23	$113.87	$31.85
73110 X-ray of wrist, minimum of 3 views	22	13	$114.82	$30.88
97035 Application of ultrasound, each 15 minutes	20	16	$30.00	$10.11
A9579 Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml	19	18	$8.00	$1.86
73222 Mri scan of arm joint with contrast	19	18	$1377.89	$283.65
99221 Initial hospital inpatient care per day, typically 30 minutes	15	15	$312.00	$100.70
27130 Replacement of thigh bone and hip joint with prosthesis	14	14	$6200.00	$1362.13
97161 Evaluation of physical therapy, typically 20 minutes	14	14	$133.00	$74.08
97162 Evaluation for physical therapy, typically 30 minutes	13	13	$153.00	$78.04
29827 Repair of shoulder rotator cuff using an endoscope	13	13	$4270.00	$976.07
29823 Removal of extensive shoulder joint tissue using an endoscope	12	12	$2889.00	$292.83
29824 Partial removal of collar bone at shoulder using an endoscope	12	12	$2705.00	$298.35
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	11	11	$2780.00	$168.44
73080 X-ray of elbow, minimum of 3 views	11	11	$103.00	$25.53

Medical Specialties & State Licenses

CMS Verified: 2026-03-05

Orthopaedic Surgery Primary Specialty

NUCC Taxonomy Code: 207X00000X

State License IL 036116081

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Orthopaedic Surgery - Sports Medicine

NUCC Taxonomy Code: 207XX0005X

State License IL 036116081

An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.

Orthopaedic Surgery - Sports Medicine

NUCC Taxonomy Code: 207XX0005X

State License IA 37086

Orthopaedic Surgery

NUCC Taxonomy Code: 207X00000X

State License IA 37086

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

1205990843 (IA)

Commercial Insurance / Payer ID Wellmark

55218 (IA)

Hospital & Practice Group Affiliations

Ora Orthopedics Pc

520 Valley View Dr, Moline, IL 612656194

Phone: 3097623621

Ora Orthopedics Pc

6101 Northwest Blvd, Davenport, IA 528061861

Phone: 5633220971

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

37 Associated Practitioners

Dr. Russell Carlson , DPM

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Doctor of Podiatric Medicine

Dr. John Baker , MD

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Doctor of Medicine (M.D.)

Dr. Michael Berry , MD

Orthopaedic Surgery

NPI 1114121969

Doctor of Medicine (M.D.)

Jennifer Miller

Physician Assistant

NPI 1134437304

John Van Straten

Anesthesiology - Pain Medicine

NPI 1164712873

Dr. Steven Boardman , MD

Orthopaedic Surgery

NPI 1174501829

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 05, 2026

Orthopaedic Surgery (License #036116081 in IL)

✅

NPI Profile Active March 18, 2011

NPI status registered as active in NPPES database

📍

Updated Practice Location March 18, 2011

Registered at 520 VALLEY VIEW DR, MOLINE, IL 612656194 (Tel: 3097623621)

📍

Updated Business Mailing Address March 18, 2011

Registered at 520 VALLEY VIEW DR, MOLINE, IL 612656194 (Tel: 3097623621)

👤

Provider Name / Credentials Updated March 18, 2011

Recorded as SHAWN WYNN, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 18, 2011

Orthopaedic Surgery (License #036116081 in IL)

🟢

Initial NPI Registration & Enumeration December 20, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1205990843

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: December 20, 2006

Last Update: March 05, 2026

Sole Proprietor: No

Update or Correct Profile

Mailing Address

520 Valley View Dr

Moline, IL 612656194

Phone: 3097623621

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

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