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
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1952082075
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OMNI YOUTH SERVICES

Provider Business Mailing Address
First Line	:	1111 W LAKE COOK RD
Second Line	:
City	:	BUFFALO GROVE
State	:	IL
Zip	:	60089-1926
Country	:	US
Telephone Number	:	847-353-1758
Fax Number	:

Provider Business Practice Location Address
First Line	:	1880 W WINCHESTER RD STE 108
Second Line	:
City	:	LIBERTYVILLE
State	:	IL
Zip	:	60048-5321
Country	:	US
Telephone Number	:	224-676-2317
Fax Number	:	847-353-1759

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DORYCE MCCARTHY
Credential	:	LCSW
Telephone Number	:	847-353-1758

Provider Enumeration Date	:	07/31/2023
Last Update Date	:	01/08/2026

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Directions to “OMNI YOUTH SERVICES ” Practice Location

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