Provider Demographics
NPI:1457810319
Name:TEKESTE, YONAS (PT, DPT)
Entity Type:Individual
Prefix:MR
First Name:YONAS
Middle Name:
Last Name:TEKESTE
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 1:872 W DAYTON ST
Mailing Address - Street 2:
Mailing Address - City:GALESBURG
Mailing Address - State:IL
Mailing Address - Zip Code:61401-1503
Mailing Address - Country:US
Mailing Address - Phone:309-344-3400
Mailing Address - Fax:309-344-5040
Practice Address - Street 1:872 W DAYTON ST
Practice Address - Street 2:
Practice Address - City:GALESBURG
Practice Address - State:IL
Practice Address - Zip Code:61401-1503
Practice Address - Country:US
Practice Address - Phone:309-344-3400
Practice Address - Fax:309-344-5040
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070023938225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist