Individual
MR. CHARLES ARTHUR EGNER II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.S.
Contact information
Practice address
301 VETERANS PKWY, NEW LENOX, IL 60451-2899
(815) 717-3770
(815) 717-3779
Mailing address
301 VETERANS PKWY, NEW LENOX, IL 60451-2899
(815) 717-3770
(815) 717-3779
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/09/2014
Last updated
07/09/2014
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