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Individual
WINSTON SEQUEIRA
Active
Individual
WINSTON SEQUEIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
036-049100
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0222075
BLUE CROSS GROUP NUMBER
IL
05
—
036049100
—
IL
01
—
1033149844
GROUP NPI
IL
01
—
363149833
TAX IDENTIFICATION NUMBER
IL
01
—
3631498336019001
CDPG HFS PAYEE ID
IL
Enumeration date
07/08/2006
Last updated
05/25/2009
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