Search › Illinois › 163WH0200X
Shela Tan-Urdaneta
NPI 1306776539 · on the registry since 2026 · sole proprietor
Practice
- Address
- 1177 Pine Tree Ct
Lake Villa, IL 60046 - Phone
- (773) 997-4917
- Fax
- (773) 901-3075
Registry record
- Primary taxonomy
- 163WH0200X
163WH0200X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2026-05-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois