NPIMap

Organization Active NPI

Haven of St Elmo, LLC

  • Skilled Nursing Facility
  • Saint Elmo, IL
National Provider Identifier
1083433155
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
HAVEN OF ST ELMO, LLC
Practice address
221 E Cumberland Rd
Saint Elmo, IL 62458-1662
Phone
(618) 829-5551
NPI assigned
Oct 7, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Authorized official

Name
Mr. Levi Israel
Title
Ceo
Phone
(847) 905-3220

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

221 E Cumberland Rd
Saint Elmo, IL 62458-1662

Mailing address

2201 Main St
Evanston, IL 60202-1519
Phone (847) 905-3222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250317000774 IL Part A Provider - Skilled Nursing Facility 2961924261 Practice locations: Saint Elmo, IL

Skilled nursing facility certification: CCN 145857

Legal name
HAVEN OF ST. ELMO LLC
Doing business as
THE HAVEN OF ST. ELMO
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Oct 1, 1995
Last certification
May 20, 2025
Beds
60
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Haven Healthcare LLC
Most recent change of ownership
Jan 30, 2014
Organization structure
LLCProprietary
Enrollment address
221 E Cumberland Rd
Saint Elmo, IL 62458-1662
Nursing home name
THE HAVEN OF ST. ELMO
Affiliated entity
HAVEN HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
The Haven of St. ElmoCCN 145857
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Oct 1, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6039.9 residents per day on average
Chain
Haven Healthcare7 facilities in the chain
Penalties (3 years)
1Fines totaling $14,015

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Individual Adp of the SNF Mar 1, 2025
Organization, Chicago, IL Adp of the SNF Mar 1, 2025
Haven Healthcare Holdings LLC Organization, Evanston, IL LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Mar 1, 2025 99.99%
5% Or Greater Indirect Ownership Interest Mar 1, 2025 0.01%
Ecapital Healthcare Corp Organization, Aventura, FL Corporation, Financial institution, Owned by another organization or individual 5% Or Greater Security Interest Mar 1, 2025 100%
Operational/Managerial Control Mar 1, 2025
William Rothner Individual Trustee of the SNF Mar 1, 2025
David Glat Individual 5% Or Greater Indirect Ownership Interest Mar 1, 2025 40%
Operational/Managerial Control Mar 1, 2025
Managing Control - Governing BodyManager Mar 1, 2025
Adp of the SNF Mar 1, 2025
Organization, Evanston, IL LLC Adp of the SNF Dec 1, 2024
Haven Healthcare LLC Organization, Evanston, IL Investment firm, Chain home office Adp of the SNF Mar 1, 2025
Michelle Blain Individual Operational/Managerial Control Mar 1, 2025
Adp of the SNF Mar 1, 2025
Nathan and Shirley Rothner Family Trust Organization, Evanston, IL 5% Or Greater Indirect Ownership Interest Mar 1, 2025 40%
Harold Katz Individual Trustee of the SNF Mar 1, 2025
Organization, Evanston, IL LLC, Holding company, Owned by another organization or individual Direct Ownership Interest Mar 1, 2025 0.01%
John a Flick Individual Operational/Managerial Control Mar 1, 2025
Adp of the SNF Mar 1, 2025
Levi Israel Individual 5% Or Greater Direct Ownership Interest Mar 1, 2025 20%
Adp of the SNF Mar 1, 2025
Organization, Skokie, IL LLC Adp of the SNF Mar 1, 2025

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 26

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

View all 26

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1728259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741305600000",
    "number": "1083433155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 MAIN ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021519",
            "telephone_number": "847-905-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 E CUMBERLAND RD",
            "city": "SAINT ELMO",
            "state": "IL",
            "postal_code": "624581662",
            "telephone_number": "618-829-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN OF ST ELMO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-07",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A",
        "authorized_official_last_name": "ISRAEL",
        "authorized_official_first_name": "LEVI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "847-905-3220",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Elmo, IL

Sources for this page

Verify at the official NPI Registry.