Active NPI
Foster Health & Rehabilitation Center LLC
- Skilled Nursing Facility
- Chicago, IL
National Provider Identifier
1104181015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- FOSTER HEALTH & REHABILITATION CENTER LLC
- Practice address
- 2840 W Foster Ave
Chicago, IL 60625-3506 - Phone
- (773) 561-2040
- Fax
- (773) 561-2060
- NPI assigned
- Jul 6, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Judd Schneider
- Title
- Manager
- Phone
- (773) 919-9813
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
2840 W Foster Ave
Chicago, IL 60625-3506
Mailing address
2840 W Foster Ave
Chicago, IL 60625-3506
Phone (773) 561-2040
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140417000042 | IL | Part A Provider - Skilled Nursing Facility | 0143452581 | Practice locations: Chicago, IL |
Skilled nursing facility certification: CCN 146167
- Legal name
- FOSTER HEALTH & REHABILITATION CENTER LLC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 24, 2014
- Last certification
- Oct 11, 2024
- Beds
- 46
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC
- Incorporated
- Jul 1, 2012 in IL
- Enrollment address
- 2840 W Foster Ave
Chicago, IL 60625-3506 - Nursing home name
- FOSTER HEALTH & REHAB CENTER
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Foster Health & Rehab Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Apr 24, 2014
- Medicare certification status
- Active
- Certified beds
- 46
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2052737 | Foster Health & Rehabilitation Center | Certificate of waiver | Jan 16, 2027 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 5
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Mendel Schneider | 5% Or Greater Direct Ownership Interest | Jul 1, 2012 | 75% |
| General Partnership Interest | Jul 1, 2012 | 75% | |
| Corporate Officer | Jul 1, 2012 | 100% | |
| Adp of the SNF | Jul 1, 2012 | ||
| Debra Brown | Operational/Managerial Control | Jul 7, 2019 | |
| Adp of the SNF | Jul 7, 2019 | ||
| Vivek Anand Gupta | Operational/Managerial Control | May 1, 2021 | |
| Adp of the SNF | May 1, 2021 | ||
| Shalom Properties | Adp of the SNF | Jul 1, 2012 | |
| Judd Schneider | 5% Or Greater Direct Ownership Interest | Jul 1, 2012 | 25% |
| General Partnership Interest | Jul 1, 2012 | 25% | |
| Corporate Officer | Jul 1, 2012 | 100% | |
| Adp of the SNF | Jul 1, 2012 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1376632976
Adp of the SNF, Operational/Managerial Control
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341532800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1455667200000",
"number": "1104181015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2840 W FOSTER AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606253506",
"telephone_number": "773-561-2040",
"fax_number": "773-561-2060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2840 W FOSTER AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606253506",
"telephone_number": "773-561-2040",
"fax_number": "773-561-2060"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FOSTER HEALTH & REHABILITATION CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-07-06",
"last_updated": "2016-02-17",
"status": "A",
"authorized_official_last_name": "SCHNEIDER",
"authorized_official_first_name": "JUDD",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "773-919-9813"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.