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Organization

OMNI YOUTH SERVICES

Active
Parent organization
OMNI YOUTH SERVICES
Other names
OMNI Youth Services-Ela
Organization subpart
Yes

Provider details

NPI number
Legal business name
OMNI YOUTH SERVICES
Authorized official
MR. SHANAN EGGER (CFO)
(847) 353-1762
Entity
Organization

Contact information

Practice address
1025 OLD MCHENRY RD, LAKE ZURICH, IL 60047-8428
(847) 540-0680
(847) 540-1427
Mailing address
1111 W LAKE COOK RD, BUFFALO GROVE, IL 60089-1926
(847) 353-1500
(847) 465-1964

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
08005
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
08005
IL
Enumeration date
02/24/2009
Last updated
01/08/2026
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