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

Individual provider Physical Therapy Clinic/Center · NPI 1679388060

Nicholas Formica, PTA is a Physical Therapy Clinic/Center in Oak Lawn, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2025
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

4061 W 95th St
Oak Lawn, IL 60453-2611
Phone: (630) 469-9200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Clinic/Center (primary) Taxonomy 261QP2000X · Licence 160010305 (IL)

Record details

NPI number1679388060
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorYes
NPI enumeratedFebruary 11, 2025
Last updated in NPPESFebruary 11, 2025
Certification dateFebruary 11, 2025
Mailing address8825 S Kolmar Ave, Hometown, IL 60456-1027

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