94 merc villager van
Just had front end aligned but when I get up to about 70 mph it shake pretty bad
Tires look OK even rotated to no avail

Have you had your suspension checked? Could be your engine is shaking from your rubber motor mounts being loose.
It could be your transmission. Could be your ball joints at the end of your tie rods.

It could be a number of things, including your tires; are they new?

I would take it to an experienced mechanic.

Check your lugnuts!! Make sure they are tight!

Just had ball joints replaced
I replaced 1 strut about a year ago, the more I think about it maybe it's the other one
Is there any way to tell with out taking it off?

Lugs nuts are tight

When was the last time you had the tires balanced? If they're slightly off, it's very possible you're only noticing the shake at higher speeds.

Been awhile will try that

Thanks