Individual
SANDRA B MARCOTTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
15900 W 101ST AVE, DYER, IN 46311
(219) 365-6333
(219) 365-8291
Mailing address
15900 W 101ST AVE, MARCOTTE MEDICAL GROUP, SC, DYER, IN 46311
(219) 365-6333
(219) 365-8291
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02002860A
IN
207Q00000X
Family Medicine Physician
036112482
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000376384
BCBS
IN
01
—
000000483369
ANTHEM
IN
01
—
036112482
ILLINOIS PUBLIC AID
IL
05
—
036112482
—
IL
01
—
90000082
BCBS
IL
01
—
9932077
BCBS
IL
01
—
DE6640
RAILROAD-DYER GROUP
IN
01
—
P00254983
RAILROAD MEDICARE
IN
01
—
P00333647
RAILROAD-DYER
IN
Enumeration date
03/14/2006
Last updated
04/08/2021
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