NPIMap

Organization Active NPI

Burgess Square Healthcare and Rehabilitation Centre, LLC

  • Skilled Nursing Facility
  • Westmont, IL
National Provider Identifier
1114204831
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
BURGESS SQUARE HEALTHCARE AND REHABILITATION CENTRE, LLC
Practice address
5801 S Cass Ave
Westmont, IL 60559-2300
Phone
(630) 971-2645
Fax
(630) 969-0617
NPI assigned
Nov 9, 2011
Last updated
Nov 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2011

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

Authorized official

Name
Mr. Anthony John Schreiber
Title
Chief Operating Officer
Phone
(630) 971-2645

Specialties & licenses 1

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

Addresses

Primary practice location

5801 S Cass Ave
Westmont, IL 60559-2300

Mailing address

5801 S Cass Ave
Westmont, IL 60559-2300
Phone (630) 971-2645

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120103000557 IL Part A Provider - Skilled Nursing Facility 6800062498 Practice locations: Westmont, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114204831. Details of each certification follow.

Skilled nursing facility certification: CCN 145219

Legal name
BURGESS SQUARE HEALTHCARE AND REHABILITATION CENTRE, LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
May 7, 1970
Last certification
Sep 27, 2024
Beds
203
Ownership / control type
Partnership
Organization structure
LLCProprietary
Enrollment address
5801 S Cass Ave
Westmont, IL 60559-2300
Nursing home name
BURGESS SQUARE HEALTHCARE CTR

Care Compare: Nursing home

Medicare Care Compare
Listed as
Burgess Square Healthcare CtrCCN 145219 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
May 7, 1970
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
203123.1 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Burgess Square Healthcare and Rehabilitation Centre LLC2 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.

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Anthony Schreiber Individual 5% Or Greater Direct Ownership Interest Jan 1, 2012 30%
John Vrba Individual 5% Or Greater Direct Ownership Interest Jan 1, 2012 44%
W-2 Managing EmployeeAdministrator Jan 1, 2012 44%
Michael Hensley Individual 5% Or Greater Direct Ownership Interest Jan 1, 2012 26%

Practitioners & affiliated clinicians

Affiliated clinicians 11

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": "1320796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320796800000",
    "number": "1114204831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 S CASS AVE",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605592300",
            "telephone_number": "630-971-2645",
            "fax_number": "630-969-0617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 S CASS AVE",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605592300",
            "telephone_number": "630-971-2645",
            "fax_number": "630-969-0617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURGESS SQUARE HEALTHCARE AND REHABILITATION CENTRE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-09",
        "last_updated": "2011-11-09",
        "status": "A",
        "authorized_official_last_name": "SCHREIBER",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "630-971-2645",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westmont, IL

Sources for this page

Verify at the official NPI Registry.