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General NPI Number Information
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NPI Number | 1528058567
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Entity Type | Individual
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Provider Name | CHARLES EDWARD KAEGI JR. MD
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Gender | Male
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Dates
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Enumeration Date | 10/21/2005
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 508 NORTH PROSPECT AVENUE
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City | PARK RIDGE
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State | IL
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Zip | 60068
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Country | US
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Telephone | 773-282-4387
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Fax | 888-959-9074
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Provider Business Mailing Address
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Address Line | 508 NORTH PROSPECT AVENUE
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City | PARK RIDGE
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State | IL
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Zip | 60068
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Country | US
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Telephone | 773-282-4387
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Fax | 888-959-9074
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036055737
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License Number State | IL
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