Three Crowns Park

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0012773 Issued in IL

Legal business name

THREE CROWNS PARK

Practice address

2323 McDaniel Ave
Evanston, IL 60201-2549

Phone

(847) 328-8700

NPI assigned

Dec 15, 2015

Organization subpart

No

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

Authorized official

Name

Philip Hemmer

Title

Executive Director

Phone

(847) 328-8700

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Skilled nursing facility certification: CCN 146199

Legal name

THREE CROWNS PARK

Certification status

Active

Provider type (POS)

Nursing home – SNF (Medicare) only

Participating since

Jun 5, 2024

Last certification

Apr 24, 2025

Beds

87 (34 certified)

Ownership / control type

Nonprofit Corporation

Multi-facility organization

Covenant Living

Organization structure

CorporationNon-profit

Incorporated

Mar 24, 1978 in IL

Enrollment address

2323 McDaniel Ave
Evanston, IL 60201-2549

Nursing home name

THREE CROWNS PARK

Affiliated entity

COVENANT LIVING

Listed as

Three Crowns ParkCCN 146199 · All quality measures

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

4 of 5

Quality measures

2 of 5

Type

Medicare

Ownership

Non profit - Corporation

Certified

Jun 5, 2024

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

3426.0 residents per day on average

Chain

Covenant Living15 facilities in the chain

Abuse citation

Cited for abuse (Care Compare abuse icon)

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Three Crowns Park2 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.

• Three Crowns Park

  • Skilled Nursing Facility
  • Evanston, IL
  • NPI 1790900470
  NPD tax ID

All disclosed owners & managing parties 8

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

Affiliated clinicians 2

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

• David Lukas Belohlavek, MD

  • Hospitalist Physician
  • Glenview, IL
  • NPI 1699410712

  Nursing home

  Care Compare affiliation
• Ashir Wahab, MD

  • Family Medicine Physician
  • Lynwood, IL
  • NPI 1376591958

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1450137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450137600000",
    "number": "1205291457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 MCDANIEL AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602012549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 MCDANIEL AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602012549",
            "telephone_number": "847-328-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE CROWNS PARK",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-15",
        "last_updated": "2015-12-15",
        "status": "A",
        "authorized_official_last_name": "HEMMER",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "847-328-8700"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IL",
            "license": "5102915",
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IL",
            "license": "0012773",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0012773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordon W. Thomsen, PA-C
• Michaela Renae Thomson, MD
• Richard B Thomson, PHD
• Steven Thorpe, LCPC
• Charles A. Thorsen III, M.D.
• Three Crowns Park
• Thrive-Mha
• Mary C Thuermer, L. AC
• Xin Tian
• Daniel J Tieman, PSY.D

• Skilled Nursing Facility in Evanston, IL
• Providers in Evanston, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2015; 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.

Verify at the official NPI Registry.