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NPI Code Detail

MEDICARE: OMNI YOUTH SERVICES

MEDICARE: OMNI YOUTH SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number : 1720525678
Entity Type Code : Organization
Provider Name (Legal Business Name) : OMNI YOUTH SERVICES
Provider Business Mailing Address
First Line : 210 N WOLF RD
Second Line :
City : WHEELING
State : IL
Zip : 60090-2922
Country : US
Telephone Number : 847-353-1500
Fax Number :
Provider Business Practice Location Address
First Line : 210 N WOLF RD
Second Line :
City : WHEELING
State : IL
Zip : 60090-2922
Country : US
Telephone Number : 847-353-1500
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DORYCE MCCARTHY
Credential :
Telephone Number : 847-353-1758
Provider Enumeration Date : 01/30/2017
Last Update Date : 01/08/2026

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Directions to “OMNI YOUTH SERVICES ” Practice Location

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