Lacie Petro, MD | |
1302 Franklin Ave Ste 1100, Normal, IL 61761-0016 | |
(309) 268-5620 | |
(309) 661-6226 |
Full Name | Lacie Petro |
---|---|
Gender | Female |
Speciality | Family Practice |
Experience | 20 Years |
Location | 1302 Franklin Ave Ste 1100, Normal, Illinois |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619189859 | NPI | - | NPPES |
833120 | Other | IL | MEDICARE GROUP PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 125-050112 (Illinois) | Secondary |
207Q00000X | Family Medicine | 036119502 (Illinois) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Advocate Bromenn Medical Center | Normal, IL | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Carle West Physician Group Inc | 8921420308 | 283 |
Entity Name | Carle West Physician Group Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1467074138 PECOS PAC ID: 8921420308 Enrollment ID: O20200613000147 |
Mailing Address | Practice Location Address |
---|---|
Lacie Petro, MD 611 W. Park St., Fapc, Urbana, IL 61801 Ph: () - | Lacie Petro, MD 1302 Franklin Ave Ste 1100, Normal, IL 61761-0016 Ph: (309) 268-5620 |
Dr. Rachel Christine Dalal, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1300 Franklin Ave Ste 100, Normal, IL 61761 Phone: 309-268-3761 Fax: 309-268-5620 | |
Ashraf Abdeljaber, M.D Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1304 Franklin Ave Ste 380, Normal, IL 61761 Phone: 309-268-3598 | |
John A. Pollastrini, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1302 Franklin Ave Ste 1100, Normal, IL 61761 Phone: 309-268-2727 Fax: 309-268-6513 | |
George Gerolimatos, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 1304 Franklin Ave, Normal, IL 61761 Phone: 309-268-3558 | |
James Steven Vales, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 109 Veronica Way, Normal, IL 61761 Phone: 309-454-4698 | |
Susan Rausch, Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2200 Fort Jesse Rd, Suite 110, Normal, IL 61761 Phone: 309-661-6290 Fax: 309-451-1354 | |
Dr. Unnati Upadhyay, MD Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 1300 Franklin Ave, Normal, IL 61761 Phone: 309-268-3598 |