NPIMap

Organization Active NPI

Phe Skilled Nursing Facility LLC

  • Skilled Nursing Facility
  • Palos Heights, IL
National Provider Identifier
1194439893
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PHE SKILLED NURSING FACILITY LLC
Practice address
7850 W College Dr
Palos Heights, IL 60463-1010
Phone
(708) 361-6990
Fax
(708) 361-7697
NPI assigned
Jan 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Authorized official

Name
Menachem Shabat
Title
Principal
Phone
(847) 745-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

7850 W College Dr
Palos Heights, IL 60463-1010

Mailing address

3450 Oakton St
Skokie, IL 60076-2951
Phone (847) 745-7000

Other names 1

  • Avantara Palos Heights Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230325000087 IL Part A Provider - Skilled Nursing Facility 9830563279 Practice locations: Palos Heights, IL

Skilled nursing facility certification: CCN 145607

Legal name
PHE SKILLED NURSING FACILITY LLC
Doing business as
AVANTARA PALOS HEIGHTS
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 15, 1989
Last certification
Nov 1, 2024
Beds
184
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Legacy Healthcare
Organization structure
LLCProprietary
Enrollment address
7850 West College Dr
Palos Heights, IL 60463-1010
Nursing home name
AVANTARA PALOS HEIGHTS
Affiliated entity
LEGACY HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Avantara Palos HeightsCCN 145607
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Mar 15, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
184155.9 residents per day on average
Chain
Legacy Healthcare89 facilities in the chain
Penalties (3 years)
3Fines totaling $22,645

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
14D0683553Avantara Palos Heights7850 W College Dr, Palos Heights, IL 60463Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Menachem Shabat Individual Corporate OfficerPresident Feb 1, 2023
GPN Family Trust U/a/D 4/28/08 Organization, Skokie, IL 5% Or Greater Direct Ownership Interest Feb 1, 2023 59.5%
Legacy Healthcare Financial Services LLC Organization, Skokie, IL LLC, For-profit Operational/Managerial Control Feb 1, 2023
Oakway Operations LLC Organization, Skokie, IL LLC, For-profit 5% Or Greater Indirect Ownership Interest Feb 1, 2023 15%
Doros Generation Trust U/a/D 1/3/12 Organization, Skokie, IL 5% Or Greater Indirect Ownership Interest Feb 1, 2023 25.5%
Valerie Elizabeth Perkovic Individual W-2 Managing EmployeeAdministrator Feb 1, 2023

Facilities with the same owner 89

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 89

Practitioners & affiliated clinicians

Affiliated clinicians 7

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": "1673222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673222400000",
    "number": "1194439893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 OAKTON ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762951",
            "telephone_number": "847-745-7000",
            "fax_number": "847-745-6267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7850 W COLLEGE DR",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631010",
            "telephone_number": "708-361-6990",
            "fax_number": "708-361-7697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHE SKILLED NURSING FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A",
        "authorized_official_last_name": "SHABAT",
        "authorized_official_first_name": "MENACHEM",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "847-745-7000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avantara Palos Heights",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palos Heights, IL

Sources for this page

Verify at the official NPI Registry.