Alexis Lynn Pultorak, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070040368 Issued in IL

Practice address

18410 Governors Hwy
Homewood, IL 60430-2911

Phone

(708) 852-2535

NPI assigned

Oct 1, 2026

Last updated

Oct 1, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1790812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790812800000",
    "number": "1073427449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4064 W 115TH ST APT 8-201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606554360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18410 GOVERNORS HWY",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302911",
            "telephone_number": "708-852-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULTORAK",
        "first_name": "ALEXIS",
        "middle_name": "LYNN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-01",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070040368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Homewood, IL
• Providers in Homewood, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.