NPIMap

Organization Active NPI

Pearl of Elk Grove, LLC

  • Skilled Nursing Facility
  • Elk Grove Village, IL
National Provider Identifier
1023722105
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PEARL OF ELK GROVE, LLC
Practice address
1920 Nerge Rd
Elk Grove Village, IL 60007-2972
Phone
(847) 301-0550
NPI assigned
Jan 12, 2023
Last updated
Jan 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Authorized official

Name
Eitan Zeffren
Title
Authorized Official
Phone
(847) 301-0550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

1920 Nerge Rd
Elk Grove Village, IL 60007-2972

Mailing address

4711 Golf Rd Ste 200
Skokie, IL 60076-1236
Phone (847) 933-9280

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230719004307 IL Part A Provider - Skilled Nursing Facility 1052785102 Practice locations: Elk Grove Village, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023722105. Details of each certification follow.

Skilled nursing facility certification: CCN 145689

Legal name
PEARL OF ELK GROVE LLC
Doing business as
THE PEARL OF ELK GROVE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 1, 1990
Last certification
Oct 23, 2024
Beds
190
Ownership / control type
Corporation
Multi-facility organization
Pearl Healthcare
Organization structure
LLCProprietary
Enrollment address
1920 Nerge Rd
Elk Grove Village, IL 60007-2972
Nursing home name
PEARL OF ELK GROVE, THE
Affiliated entity
PEARL HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Pearl of Elk Grove, theCCN 145689 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Nov 1, 1990
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
190156.3 residents per day on average
Chain
Pearl Healthcare15 facilities in the chain
Penalties (3 years)
6Fines totaling $144,133

Processed by Care Compare on Aug 1, 2026.

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
14D0678324Pearl of Elk Grove1920 Nerge Road, Elk Grove Village, IL 60007Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Ben Cohen Trust Fbo John C. Davison Organization, Baltimore, MD 5% Or Greater Indirect Ownership Interest Feb 1, 2023 7.11%
Ez Holdco LLC Organization, Lincolnwood, IL LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Feb 1, 2023 60%
Madiha Waheed Individual W-2 Managing EmployeeAd; Feb 1, 2023
Ben Cohen Trust Fbo Mark Edward Davison Organization, Baltimore, MD 5% Or Greater Indirect Ownership Interest Feb 1, 2023 7.11%
Eitan Zeffren Individual 5% Or Greater Indirect Ownership Interest Feb 1, 2023 60%
Corporate OfficerManager Feb 1, 2023
Elk Grove Holding Company, LLC Organization, Skokie, IL LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Feb 1, 2023 99.99%
Wahaj Ahmed Individual Contracted Managing EmployeeMD; Feb 1, 2023
Ben Cohen Trust Fbo Joanna Davison Organization, Baltimore, MD 5% Or Greater Indirect Ownership Interest Feb 1, 2023 7.11%
Reg 2018 Irrevocable Trust U/a/D 1/1/18 Organization, Skokie, IL 5% Or Greater Indirect Ownership Interest Feb 1, 2023 10%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 13

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

View all 13

Practitioners & affiliated clinicians

Affiliated clinicians 8

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

NPI Registry JSON

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

{
    "created_epoch": "1673481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673481600000",
    "number": "1023722105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 GOLF RD STE 200",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761236",
            "telephone_number": "847-933-9280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 NERGE RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600072972",
            "telephone_number": "847-301-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARL OF ELK GROVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-12",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-11",
        "status": "A",
        "authorized_official_last_name": "ZEFFREN",
        "authorized_official_first_name": "EITAN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "847-301-0550"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

Verify at the official NPI Registry.