Healthcare Provider Details

I. General information

NPI: 1316276801
Provider Name (Legal Business Name): TANYA C MCHALE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2009
Last Update Date: 12/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 LAKE ST SUITE 516
OAK PARK IL
60301-1422
US

IV. Provider business mailing address

715 LAKE ST SUITE 516
OAK PARK IL
60301-1422
US

V. Phone/Fax

Practice location:
  • Phone: 708-725-3025
  • Fax: 708-848-3031
Mailing address:
  • Phone: 708-725-3025
  • Fax: 708-848-3031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number041316822
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: