| Doctor Name: | DR. KAYLEE YATES |
| NPI Number: | 1588056659 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | 070021291 |
| Business Practice Address: | 8415 Bethalto Rd Bethalto, IL - 620102559 |
| Business Phone Number: | 6187910579 |
| Business Fax Number: | |
| Mailing Address: | 8415 Bethalto Rd, BETHALTO |
| State: | IL |
| Postal Code: | 620102559 |
| Phone Number: | 6187910579 |
| Fax Number: | |
| NPI Enumeration Date: | 02/26/2015 |
| NPI Last Update Date: | 02/26/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251P0200X |
| License Number: | 070021291 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |