NPIMap

Organization Active NPI

Suncrest Hospice Illinois LLC

Doing business as Suncrest Hospice

  • Community Based Hospice Care Agency
  • Northbrook, IL
National Provider Identifier
1003340050
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
SUNCREST HOSPICE ILLINOIS LLC
Doing business as
Suncrest Hospice
Practice address
5 Revere Dr Ste 130
Northbrook, IL 60062-8004
Phone
(847) 983-0017
NPI assigned
Apr 17, 2017
Last updated
Jul 1, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
SUNCREST HEALTH SERVICES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Authorized official

Name
Christopher Harris
Title
Ceo
Phone
(801) 849-0486

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

5 Revere Dr Ste 130
Northbrook, IL 60062-8004

Mailing address

9800 S Monroe St Ste 900
Sandy, UT 84070-4419
Phone (801) 849-0486

Other names 1

  • Suncrest Hospice Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tosborne@suncrestcare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171130000467 IL Part A Provider - Hospice 1254698293 Practice locations: Northbrook, IL; Westmont, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003340050. Details of each certification follow.

Hospice certification: CCN 141696

Legal name
SUNCREST HOSPICE ILLINOIS LLC
Doing business as
SUNCREST HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jan 1, 2018
Last certification
Jan 1, 2018
Ownership / control type
Proprietary - Other
Organization structure
LLCProprietary
Incorporated
Nov 23, 2016 in UT
Enrollment address
5 Revere Dr
Ste 130
Northbrook, IL 60062-8004

Care Compare: Hospice

Medicare Care Compare
Listed as
Suncrest Hospice Illinois LLCCCN 141696 · All quality measures
Ownership
For-Profit
Certified
Jan 1, 2018
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2133761Suncrest Hospice Illinois5 Revere Dr - Ste 130, Northbrook, IL 60062Certificate of waiverJul 18, 2027

National Provider Directory

National Provider Directory

Locations

5 Revere Dr
Ste 130
Northbrook, IL 60062
Phone (847) 983-0017

777 Oakmont Ln
Ste 1400
Westmont, IL 60559
Phone (630) 743-6477

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Marek J Grzeskowiak Individual W-2 Managing EmployeeMD; Oct 20, 2025
Scott David Perucca Individual 5% Or Greater Indirect Ownership Interest Jan 3, 2024 34.2%
Corporate OfficerCso Nov 23, 2016 34.2%
Operational/Managerial ControlCso Nov 23, 2016 34.2%
Christopher Jay Harris Individual 5% Or Greater Indirect Ownership InterestCeo Jan 3, 2024 5%
Corporate OfficerCeo Jan 3, 2022 5%
Erin M Bennett Individual 5% Or Greater Indirect Ownership Interest Jan 3, 2024 13.3%
Tyler M Godfrey Individual 5% Or Greater Indirect Ownership Interest Jan 3, 2024 34.2%
Corporate OfficerCio Nov 23, 2016 34.2%
Operational/Managerial ControlCio Nov 23, 2016 34.2%
Kenneth M Breger Individual Contracted Managing EmployeeMD; Jan 1, 2024 100%
Thomas B Godfrey Individual 5% Or Greater Indirect Ownership Interest Jan 3, 2024 13.3%
Suncrest Health Services LLC Organization, Sandy, UT LLC 5% Or Greater Direct Ownership Interest Nov 23, 2016 100%
Sarah Eileen Nielsen Individual W-2 Managing EmployeeAd; Jan 3, 2024
G&B Newco Inc Organization, Sandy, UT Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 3, 2024 26.6%
Dawn Anderson Individual W-2 Managing EmployeeAd; Jan 1, 2024 100%

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 40

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 40

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 104

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 104

NPI Registry JSON

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782864000000",
    "number": "1003340050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9800 S MONROE ST STE 900",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840704419",
            "telephone_number": "801-849-0486",
            "fax_number": "801-849-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 REVERE DR STE 130",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600628004",
            "telephone_number": "847-983-0017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNCREST HOSPICE ILLINOIS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUNCREST HEALTH SERVICES LLC",
        "enumeration_date": "2017-04-17",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-849-0486"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tosborne@suncrestcare.com",
            "affiliation": "N",
            "endpointDescription": "Medicare Biller email",
            "address_1": "5 Revere Dr Ste 130",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600628004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Suncrest Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Suncrest Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.