Healthcare Provider Details

I. General information

NPI: 1487148318
Provider Name (Legal Business Name): COLLEEN SHANDLEY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2018
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4885 HOFFMAN BLVD STE 300
HOFFMAN ESTATES IL
60192-3727
US

IV. Provider business mailing address

4885 HOFFMAN BLVD STE #300
HOFFMAN ESTATES IL
60192
US

V. Phone/Fax

Practice location:
  • Phone: 847-454-7828
  • Fax:
Mailing address:
  • Phone: 224-612-3191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number019.031833
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: