Provider Demographics
NPI:1801426705
Name:RECLA, ALVIC GARCIA (PT)
Entity type:Individual
Prefix:MR
First Name:ALVIC
Middle Name:GARCIA
Last Name:RECLA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 SPRING RD STE 200
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1837
Mailing Address - Country:US
Mailing Address - Phone:630-481-4434
Mailing Address - Fax:
Practice Address - Street 1:9519 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-1211
Practice Address - Country:US
Practice Address - Phone:847-390-0999
Practice Address - Fax:847-390-0949
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-19
Last Update Date:2023-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.024846225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist