Basic Information
| Provider Information | |||||||||
| NPI: | 1699986588 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARCOTTE FISHER | ||||||||
| FirstName: | RACHELLE | ||||||||
| MiddleName: | N. | ||||||||
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| Credential: | DT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2067 LOCUST RD | ||||||||
| Address2: | |||||||||
| City: | MORRIS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604503609 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2423 GLENWOOD AVE | ||||||||
| Address2: | |||||||||
| City: | JOLIET | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604355483 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8157259992 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2007 | ||||||||
| LastUpdateDate: | 03/26/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 222Q00000X | RM88390307P | IL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Developmental Therapist |
No ID Information.