Provider Demographics
NPI:1316276801
Name:MCHALE, TANYA C (RN)
Entity type:Individual
Prefix:MS
First Name:TANYA
Middle Name:C
Last Name:MCHALE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 LAKE ST
Mailing Address - Street 2:SUITE 516
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1422
Mailing Address - Country:US
Mailing Address - Phone:708-725-3025
Mailing Address - Fax:708-848-3031
Practice Address - Street 1:715 LAKE ST
Practice Address - Street 2:SUITE 516
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1422
Practice Address - Country:US
Practice Address - Phone:708-725-3025
Practice Address - Fax:708-848-3031
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041316822163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn