| Doctor Name: | LESLIE D YEATES |
| NPI Number: | 1497839724 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 085-001038 |
| Business Practice Address: | 400 South Kennedy Dr Bradley, IL - 60915 |
| Business Phone Number: | 8159288050 |
| Business Fax Number: | 8159289858 |
| Mailing Address: | 400 South Kennedy Dr, BRADLEY |
| State: | IL |
| Postal Code: | 60915 |
| Phone Number: | 8159288050 |
| Fax Number: | 8159289858 |
| NPI Enumeration Date: | 10/24/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 085-001038 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |