NPIMap

Organization Active NPI

Omni Youth Services

  • Community/Behavioral Health Agency
  • Arlington Heights, IL
National Provider Identifier
1205076858
Registry record updated Feb 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
08005 Issued in IL
Legal business name
OMNI YOUTH SERVICES
Practice address
1616 N Arlington Heights Rd
Arlington Heights, IL 60004-3981
Phone
(847) 253-6010
Fax
(847) 253-7230
NPI assigned
Feb 23, 2009
Last updated
Feb 23, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
OMNI YOUTH SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 23, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Shanan Egger
Title
Cfo
Phone
(847) 353-1762

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 08005 IL Primary

Addresses

Primary practice location

1616 N Arlington Heights Rd
Arlington Heights, IL 60004-3981

Mailing address

1111 W Lake Cook Rd
Buffalo Grove, IL 60089-1926
Phone (847) 353-1500

Other identifiers 1

IdentifierTypeStateIssuer
08005MedicaidIL

Other names 1

  • OMNI Youth Services-Arlington Heights Other name

National Provider Directory

National Provider Directory
Tax ID family
Omni Youth Services Inc11 organizations share this tax ID, including this one
Part of
Omni Youth Services Inc

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1616 N Arlington Heights Rd
Arlington Heights, IL 60004
Phone (847) 392-0265

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235347200000",
    "number": "1205076858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W LAKE COOK RD",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891926",
            "telephone_number": "847-353-1500",
            "fax_number": "847-465-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 N ARLINGTON HEIGHTS RD",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600043981",
            "telephone_number": "847-253-6010",
            "fax_number": "847-253-7230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI YOUTH SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OMNI YOUTH SERVICES",
        "enumeration_date": "2009-02-23",
        "last_updated": "2009-02-23",
        "status": "A",
        "authorized_official_last_name": "EGGER",
        "authorized_official_first_name": "SHANAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "847-353-1762",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "08005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08005",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OMNI Youth Services-Arlington Heights",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.