Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LACIE PETRO, M.D.
ActiveLACIE PETRO, M.D. is a Family Medicine healthcare provider located in NORMAL, Illinois. NPI 1619189859 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · NORMAL, IL
Registration Details
- NPI Number
- 1619189859
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- May 3, 2007 (19.286070758465 yrs)
- Last Updated
- Feb 12, 2021
- Licenses
-
125-050112 (IL)036119502 (IL)
Practice Information
- Address
-
1302 FRANKLIN AVE STE 1100NORMAL, IL, 617610016Browse IL providers · Browse ZIP 61761
- Phone
- 3092685620
- Fax
- 3096616226
- Primary Specialty
-
Family Medicine
207Q00000X
- Additional Specialty
- Family Medicine
Other Family Medicine Providers in NORMAL, IL
| Name | Credential | NPI |
|---|---|---|
| LINDA S MOORHEAD | MD | 1811957152 |
| DR. MADHAVI MADUGULA | M.D. | 1144266065 |
| DR. MARCIA K. HAUTER | — | 1548288327 |
| DR. JULIANA R. KAMINSKI | D.O. | 1194747527 |
| JOHN A. POLLASTRINI | M.D. | 1033131479 |
| TODD OWEN KETTERING | D.O. | 1972619526 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.