NPIMap

Organization Active NPI

Guardian Healthcare and Hospice,LLC

  • Community Based Hospice Care Agency
  • Northfield, IL
National Provider Identifier
1124279815
Registry record updated Aug 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
GUARDIAN HEALTHCARE AND HOSPICE,LLC
Practice address
181 Waukegan Rd
Suite 301
Northfield, IL 60093-2755
Phone
(847) 446-0000
NPI assigned
Oct 1, 2008
Last updated
Aug 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2011

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

Authorized official

Name
Peter Mandellos
Title
Administrator
Phone
(846) 446-0000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X NU Primary

Addresses

Primary practice location

181 Waukegan Rd
Suite 301
Northfield, IL 60093-2755

Mailing address

181 Waukegan Rd
Suite 301
Northfield, IL 60093-2755
Phone (847) 446-0000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090122000333 IL Part A Provider - Hospice 6204990088 Practice locations: Northfield, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124279815. Details of each certification follow.

Hospice certification: CCN 141630

Legal name
GUARDIAN HEALTHCARE AND HOSPICE,LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 8, 2009
Last certification
May 8, 2009
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Enrollment address
181 Waukegan Rd
Suite 301
Northfield, IL 60093-3386

Care Compare: Hospice

Medicare Care Compare
Listed as
Guardian Healthcare & Hospice, LLCCCN 141630 · All quality measures
Ownership
For-Profit
Certified
May 8, 2009
Medicare certification status
ActiveFrom the Provider of Services file

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
14D2092335Guardian Healthcare & Hospice, LLC181 Waukegan Rd, Ste 301, Northfield, IL 60093Certificate of waiverJul 19, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Panagiotis Mandellos Individual 5% Or Greater Direct Ownership Interest Jan 13, 2009
General Partnership Interest Jan 13, 2009
W-2 Managing Employee Jan 13, 2009
Helen Smekhov Individual 5% Or Greater Direct Ownership Interest Jan 13, 2009
General Partnership Interest Jan 13, 2009
W-2 Managing EmployeeAd; Jan 13, 2009

Practitioners & affiliated clinicians

Affiliated clinicians 29

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 29

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312243200000",
    "number": "1124279815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 WAUKEGAN RD",
            "address_2": "SUITE 301",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600932755",
            "telephone_number": "847-446-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 WAUKEGAN RD",
            "address_2": "SUITE 301",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600932755",
            "telephone_number": "847-446-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN HEALTHCARE AND HOSPICE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-01",
        "last_updated": "2011-08-02",
        "status": "A",
        "authorized_official_last_name": "MANDELLOS",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "846-446-0000"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, IL

Sources for this page

Verify at the official NPI Registry.