Organization Active NPI

Pearl of Downers Grove LLC

  • Skilled Nursing Facility
  • Downers Grove, IL
National Provider Identifier
1104625078
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PEARL OF DOWNERS GROVE LLC
Practice address
3450 Saratoga Ave
Downers Grove, IL 60515-1141
Phone
(630) 969-2900
NPI assigned
Mar 12, 2025
Last updated
Mar 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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
(630) 969-2900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

3450 Saratoga Ave
Downers Grove, IL 60515-1141

Mailing address

6865 N Lincoln Ave
Lincolnwood, IL 60712-4611

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250724001136 IL Part A Provider - Skilled Nursing Facility 4486160561 Practice locations: Downers Grove, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104625078. Details of each certification follow.

Skilled nursing facility certification: CCN 145657

Legal name
PEARL OF DOWNERS GROVE LLC
Doing business as
THE PEARL OF DOWNERS GROVE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Aug 22, 1989
Last certification
Apr 14, 2025
Beds
145
Ownership / control type
Corporation
Multi-facility organization
Hill Valley Healthcare
Organization structure
LLCProprietary
Enrollment address
3450 Saratoga Ave
Downers Grove, IL 60515-1141
Nursing home name
THE PEARL OF DOWNERS GROVE
Affiliated entity
PEARL HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
The Pearl of Downers GroveCCN 145657 · All quality measures
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 - Corporation
Certified
Aug 22, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
14592.9 residents per day on average
Chain
Pearl Healthcare15 facilities in the chain
Penalties (3 years)
1Fines totaling $30,794

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
14D0668109Pearl of Downers Grove, the3450 Saratoga Ave, Downers Grove, IL 60515Certificate of waiverAug 31, 2026
14D2330067Pearl of Downers Grove, the3450 Saratoga Ave, Downers Grove, IL 60515Certificate of waiverSep 9, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 26

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

NameRoleSinceShare
Ez Holdco LLC Organization, Lincolnwood, IL LLC, Holding company Adp of the SNF Apr 10, 2025
Direct Ownership Interest Apr 10, 2025 0.01%
Indirect Ownership Interest Apr 10, 2025 59.81%
Individual Indirect Ownership Interest Apr 10, 2025 2.4%
Individual Indirect Ownership Interest Apr 10, 2025 0.19%
Shahaab Uddin Individual Operational/Managerial Control Apr 10, 2025
Adp of the SNF Apr 10, 2025
Organization, Baltimore, MD LLC, Owned by another organization or individual Indirect Ownership Interest Apr 10, 2025 1.2%
Organization, Chicago, IL Indirect Ownership Interest Apr 10, 2025 2.4%
Individual Trustee of the SNF Apr 10, 2025
Individual Indirect Ownership Interest Apr 10, 2025 2%
Pearlstone Consulting LLC Organization, Lincolnwood, IL LLC Operational/Managerial Control Apr 10, 2025
Adp of the SNF Apr 10, 2025
Individual Indirect Ownership Interest Apr 10, 2025 1.2%
Individual Indirect Ownership Interest Apr 10, 2025 0.98%
Eitan Zeffren Individual Operational/Managerial Control Apr 10, 2025
Managing Control - Governing BodyManager Apr 10, 2025
Adp of the SNF Apr 10, 2025
Indirect Ownership Interest Apr 10, 2025 59.81%
Hooli Holdings LLC Organization, Lincolnwood, IL LLC, Holding company Adp of the SNF Apr 10, 2025
Indirect Ownership Interest Apr 10, 2025 10%
Individual Indirect Ownership Interest Apr 10, 2025 0.4%
Individual Adp of the SNF Apr 10, 2025
Indirect Ownership Interest Apr 10, 2025 10%
Individual Indirect Ownership Interest Apr 10, 2025 2%
Organization, Farmingdale, NJ Indirect Ownership Interest Apr 10, 2025 1.02%
Organization, Chicago, IL LLC Adp of the SNF Apr 10, 2025
Reg 2018 Irrevocable Trust U/a/D 1/1/18 Organization, Skokie, IL Adp of the SNF Apr 10, 2025
Indirect Ownership Interest Apr 10, 2025 11%
Individual Indirect Ownership Interest Apr 10, 2025 2%
Organization, Englewood, NJ Indirect Ownership Interest Apr 10, 2025 2%
Organization, Farmingdale, NJ LLC, Owned by another organization or individual Indirect Ownership Interest Apr 10, 2025 2%
Organization, Saint Louis, MO Indirect Ownership Interest Apr 10, 2025 1.2%
Individual Direct Ownership Interest Apr 10, 2025 100%
Lisa Williams Individual Operational/Managerial Control Apr 10, 2025
Adp of the SNF Apr 10, 2025
Organization, Chicago, IL LLC Adp of the SNF Apr 10, 2025

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1741737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741737600000",
    "number": "1104625078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6865 N LINCOLN AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607124611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 SARATOGA AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151141",
            "telephone_number": "630-969-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARL OF DOWNERS GROVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-12",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A",
        "authorized_official_last_name": "ZEFFREN",
        "authorized_official_first_name": "EITAN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "630-969-2900"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

Verify at the official NPI Registry.