Individual
GREGORY T WINTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2350 ROYAL BLVD, SUITE 300, ELGIN, IL 60123-4719
(847) 742-3120
(847) 742-4021
Mailing address
2350 ROYAL BLVD, SUITE 300, ELGIN, IL 60123-4719
(847) 742-3120
(847) 742-4021
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036077502
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-077502
IL STATE LICENSE
IL
05
—
362742950-60123-01
—
IL
01
—
4515545
BCBS IL PROVIDER NUMBER
IL
Enumeration date
07/29/2005
Last updated
12/29/2021
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