NPIMap

Organization Active NPI

Allure of Mendota, LLC

  • Skilled Nursing Facility
  • Mendota, IL
National Provider Identifier
1053007443
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
ALLURE OF MENDOTA, LLC
Practice address
1201 1St Ave
Mendota, IL 61342-1815
Phone
(815) 539-6745
NPI assigned
Apr 18, 2023
Last updated
Aug 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Authorized official

Name
Samantha Meyer
Title
Vice President
Phone
(733) 384-4007

Specialties & licenses 1

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

Addresses

Primary practice location

1201 1St Ave
Mendota, IL 61342-1815

Mailing address

2711 W Howard St
Chicago, IL 60645-1303
Phone (773) 338-4400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230829003565 IL Part A Provider - Skilled Nursing Facility 9830552470 Practice locations: Mendota, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053007443. Details of each certification follow.

Skilled nursing facility certification: CCN 145151

Legal name
ALLURE OF MENDOTA LLC
Doing business as
ALLURE OF MENDOTA
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 1, 1967
Last certification
Nov 15, 2024
Beds
85
Ownership / control type
Corporation
Multi-facility organization
Allure HCS
Most recent change of ownership
Jul 1, 2023
Organization structure
LLCProprietary
Incorporated
Apr 3, 2023 in IL
Enrollment address
1201 1St Ave
Mendota, IL 61342-1815
Nursing home name
ALLURE OF MENDOTA
Affiliated entity
ALLURE HEALTHCARE SERVICES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Allure of MendotaCCN 145151 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Apr 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8568.4 residents per day on average
Chain
Allure Healthcare Services15 facilities in the chain
Penalties (3 years)
3Fines totaling $28,669

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Allure of Mendota2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1201 1st Ave
Mendota, IL 61342
Phone (800) 397-1313

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
David Wengrow Individual 5% Or Greater Direct Ownership Interest Jul 1, 2023 10%
Samantha Meyer Individual Corporate OfficerVice President Jul 1, 2023
Michael Nudell Individual 5% Or Greater Indirect Ownership Interest Jul 1, 2023 30%
Operational/Managerial ControlManager of the Manager Jul 1, 2023
Kari Lazzaroto Individual W-2 Managing EmployeeFacility Administrator Jul 1, 2023
Meyer Bentzion Oseroff Individual 5% Or Greater Direct Ownership Interest Jul 1, 2023 30%
Operational/Managerial ControlManager Jul 1, 2023
MN1 Management Corp Organization, Chicago, IL Corporation, Holding company, For-profit 5% Or Greater Direct Ownership Interest Jul 1, 2023 30%
Operational/Managerial Control Jul 1, 2023
Jeremy Goldberg Individual 5% Or Greater Direct Ownership Interest Jul 1, 2023 30%
Operational/Managerial ControlManager Jul 1, 2023

Facilities with the same owner 14

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

View all 14

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1681776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693440000000",
    "number": "1053007443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 W HOWARD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606451303",
            "telephone_number": "773-338-4400",
            "fax_number": "773-338-4414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 1ST AVE",
            "city": "MENDOTA",
            "state": "IL",
            "postal_code": "613421815",
            "telephone_number": "815-539-6745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLURE OF MENDOTA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-18",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "733-384-4007"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mendota, IL

Sources for this page

Verify at the official NPI Registry.