Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lacie Petro, MD

Individual provider Family Medicine Physician · NPI 1619189859

Lacie Petro, MD is a Family Practice in Normal, Illinois. Qualified in 2005, 21 years ago. Practices with Carle West Physician Group Inc, a 285-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
21
Licensed in
IL
In the registry since
2007
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1302 Franklin Ave Ste 1100
Normal, IL 61761-0016
Phone: (309) 268-5620
Fax: (309) 661-6226
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 036119502 (IL)
Family Medicine Physician Taxonomy 207Q00000X · Licence 125-050112 (IL)

Record details

NPI number1619189859
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 3, 2007
Last updated in NPPESFebruary 12, 2021
Certification dateJanuary 27, 2021
Mailing address611 W. Park St., Fapc, Urbana, IL 61801

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Carle West Physician Group Inc — 285 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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