Active NPI
Bristol Hospice - Chicago, L.L.C.
- Community Based Hospice Care Agency
- Des Plaines, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- BRISTOL HOSPICE - CHICAGO, L.L.C.
- Practice address
- 2800 S River Rd Ste 440
Des Plaines, IL 60018-4202 - Phone
- (872) 777-1750
- Fax
- (872) 702-6450
- NPI assigned
- Sep 14, 2022
- Last updated
- Sep 16, 2026
- Organization subpart
- Yes
- Parent organization
- BRISTOL HOSPICE, L.L.C.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Alex Mauricio
- Title
- President
- Phone
- (801) 325-0175
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
2800 S River Rd Ste 440
Des Plaines, IL 60018-4202
Mailing address
206 N 2100 W Ste 202
Salt Lake City, UT 84116-4741
Phone (801) 325-0175
Other practice location 1
745 McClintock Dr Ste 215
Burr Ridge, IL 60527-0863
Phone (331) 265-8900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 2
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1104548478. Details of each certification follow.
Hospice certification: CCN 141727
- Legal name
- BRISTOL HOSPICE - CHICAGO LLC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Jul 6, 2023
- Last certification
- Jun 30, 2023
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- LLC
- Incorporated
- Jun 29, 2022 in IL
- Enrollment address
- 701 Lee St
Ste 480
Des Plaines, IL 60016-4546
Care Compare: Hospice
Medicare Care Compare- Listed as
- Bristol Hospice - Chicago, LLC
- Certified
- Jul 6, 2023
- Medicare certification status
- Active
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 |
|---|---|---|---|
| 14D2273091 | Bristol Hospice - Chicago LLC | Certificate of waiver | Dec 5, 2026 |
National Provider Directory
National Provider Directory- Tax ID family
- Bristol Hospice - Chicago
- Part of
- Bristol Hospice LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community Based Hospice Care Agency
- Joliet, IL
- NPI 1740191766
Locations
745 McClintock Dr
Ste 215
Burr Ridge, IL 60527
Phone (331) 265-8900
2800 S River Rd
Ste 440
Des Plaines, IL 60018
Phone (872) 777-1750
206 N 2100 W
Ste 202
Slc, UT 84116
Phone (801) 325-0175
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Bristol Hospice Holdings Inc | 5% Or Greater Indirect Ownership Interest | Feb 10, 2023 | 100% |
| Alex Edward Mauricio | Corporate Officer | Jan 1, 2023 | |
| Corporate Director | Jan 1, 2023 | ||
| Webster Equity Partners Bristol CF LP | 5% Or Greater Indirect Ownership Interest | Feb 10, 2023 | 69.8% |
| John Charles Garbarino | Corporate Officer | Oct 26, 2020 | |
| Corporate Director | Oct 26, 2020 | ||
| Webster Equity Partners IV Bristol CF LP | 5% Or Greater Indirect Ownership Interest | Feb 10, 2023 | 5.72% |
| Michael Derrick | Corporate Officer | Sep 1, 2023 | |
| Betty J Brennan | Corporate Director | Jul 13, 2018 | |
| Bristol Ultimate Holdco, LP | 5% Or Greater Indirect Ownership Interest | Feb 10, 2023 | 100% |
| Hyrum Kirton | Corporate Director | Oct 26, 2020 | |
| Aftab Kagzi | W-2 Managing Employee | Jan 2, 2025 | |
| Aware Super Pty, LTD. | 5% Or Greater Indirect Ownership Interest | Jan 24, 2022 | 8.28% |
| Bristol Hospice, L.L.C. | 5% Or Greater Direct Ownership Interest | Feb 10, 2023 | 100% |
| Sachin K Jain | Contracted Managing Employee | Nov 1, 2023 | |
| Bristol Hospice Topco Inc | 5% Or Greater Indirect Ownership Interest | Feb 10, 2023 | 100% |
| David a Malm | Corporate Officer | Oct 26, 2020 | |
| Corporate Director | Oct 26, 2020 |
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
- Waukegan, IL
- NPI 1326292228
Contracted Managing Employee
Facilities with the same owner 52
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Community Based Hospice Care Agency
- Bangor, ME
- NPI 1336916469
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Bend, OR
- NPI 1356916845
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Plymouth Meeting, PA
- NPI 1356118467
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Merced, CA
- NPI 1487603452
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- North Charleston, SC
- NPI 1326866963
Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Springfield, OR
- NPI 1568962033
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Atlanta, GA
- NPI 1558663872
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Green Bay, WI
- NPI 1356928154
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
dba Bristol Healthcare Services
- Community Based Hospice Care Agency
- Honolulu, HI
- NPI 1811045594
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
dba Bristol Hospice - Inland Empire
- Community Based Hospice Care Agency
- Riverside, CA
- NPI 1043683170
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
dba All Saints Hospice, Inc.
- Community Based Hospice Care Agency
- Ontario, CA
- NPI 1013318112
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Madison, WI
- NPI 1992382733
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
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.
-
- Nurse Practitioner
- Des Plaines, IL
- NPI 1225543937
Affiliated clinicians 4
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Emergency Medical Services (Emergency Medicine) Physician
- McHenry, IL
- NPI 1780636720
Hospice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663113600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1789516800000",
"number": "1104548478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "206 N 2100 W STE 202",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841164741",
"telephone_number": "801-325-0175",
"fax_number": "801-478-3533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 S RIVER RD STE 440",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "600184202",
"telephone_number": "872-777-1750",
"fax_number": "872-702-6450"
}
],
"practiceLocations": [
{
"address_1": "745 McClintock Dr Ste 215",
"address_purpose": "LOCATION",
"city": "Burr Ridge",
"state": "IL",
"postal_code": "605270863",
"country_code": "US",
"telephone_number": "331-265-8900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "BRISTOL HOSPICE - CHICAGO, L.L.C.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "BRISTOL HOSPICE, L.L.C.",
"enumeration_date": "2022-09-14",
"last_updated": "2026-09-16",
"certification_date": "2026-09-16",
"status": "A",
"authorized_official_last_name": "MAURICIO",
"authorized_official_first_name": "ALEX",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "801-325-0175",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Des Plaines, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; 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.