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Individual

WINSTON SEQUEIRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7 BLANCHARD CIR, SUITE 202, WHEATON, IL 60189-2037
(630) 653-4526
Mailing address
7 BLANCHARD CIR, SUITE 202, WHEATON, IL 60189-2037
(630) 653-4526

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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