Nicholas Formica, PTA

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

160010305 Issued in IL

Practice address

4061 W 95TH St
Oak Lawn, IL 60453-2611

Phone

(630) 469-9200

NPI assigned

Feb 11, 2025

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1739232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1679388060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8825 S KOLMAR AVE",
            "city": "HOMETOWN",
            "state": "IL",
            "postal_code": "604561027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4061 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532611",
            "telephone_number": "630-469-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMICA",
        "first_name": "NICHOLAS",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-11",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "IL",
            "license": "160010305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Foot & Ankle Associates LTD
• Foot & Ankle Health Center, P.C.
• Kelsey Foran, PT, DPT
• Andrew H Ford, MD
• Veronica Arlean Ford, OT
• Nicholas Fornatto, DMD
• Steven James Fornero, H.I.S.
• Anthony Foscolos
• Foti Chronopoulos MD SC (Women's Care Group)
• Mary V Fowler, CPNP

• Physical Therapy Clinic/Center in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Physical Therapy Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.