IndividualActive
Charles Egner, B.S.
NPI 1114333259 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · New Lenox, IL
Provider details
- NPI number
- 1114333259
- Entity type
- Individual
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Credential
- B.S.
- Sex
- Male
- Sole proprietor
- Yes
Practice location
301 Veterans Pkwy
New Lenox, IL 60451-2899
Phone: (815) 717-3770
Fax: (815) 717-3779
Mailing address
301 Veterans Pkwy
New Lenox, IL 60451-2899
Registry dates
- Enumerated
- 2014-07-09
- Last updated
- 2014-07-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.