Provider Demographics
NPI:1821330085
Name:YENILMEZ, TOLGA LEVENT (PT, DPT)
Entity Type:Individual
Prefix:MR
First Name:TOLGA
Middle Name:LEVENT
Last Name:YENILMEZ
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4753 N BROADWAY ST # SYE1014
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-5266
Mailing Address - Country:US
Mailing Address - Phone:608-444-9146
Mailing Address - Fax:
Practice Address - Street 1:4753 N BROADWAY ST STE 1014
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-4990
Practice Address - Country:US
Practice Address - Phone:608-444-9146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-25
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR62038225100000X
NY031908-1225100000X
WI12266-24225100000X
IL070020639225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist