Organization Active NPI

Laureate Chicago Operations LLC

  • Skilled Nursing Facility
  • Chicago, IL
National Provider Identifier
1205488947
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LAUREATE CHICAGO OPERATIONS LLC
Practice address
4314 S Wabash Ave
Chicago, IL 60653-3119
Phone
(773) 538-8300
Fax
(773) 538-5775
NPI assigned
Jul 12, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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

Authorized official

Name
Mr. Shaun Ahmad
Title
Manager
Phone
(704) 426-8849

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

4314 S Wabash Ave
Chicago, IL 60653-3119

Mailing address

13024 Ballantyne Corporate PL Ste 425
Charlotte, NC 28277-4420
Phone (704) 426-8849

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191025000557 IL Part A Provider - Skilled Nursing Facility 5193057065 Practice locations: Chicago, IL

Skilled nursing facility certification: CCN 146164

Legal name
LAUREATE CHICAGO OPERATIONS LLC
Doing business as
COMMUNITY CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Nov 6, 2012
Last certification
Aug 2, 2024
Beds
204
Ownership / control type
Corporation
Most recent change of ownership
Aug 30, 2019
Organization structure
LLCProprietary
Incorporated
Feb 28, 2019 in DE
Enrollment address
4314 S Wabash Ave
Chicago, IL 60653-3119
Nursing home name
ASPYRE OF BRONZEVILLE
Affiliated entity
ALIYA HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Aspyre of BronzevilleCCN 146164
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Nov 6, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
204141.6 residents per day on average
Chain
Aliya Healthcare14 facilities in the chain
Penalties (3 years)
5Fines totaling $107,000

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

13024 Ballantyne Corporate Pl
Ste 425
Charlotte, NC 28277

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Laureate Chicagoland Holdings LLC Organization, Charlotte, NC Created for acquisition, LLC 5% Or Greater Direct Ownership Interest Aug 30, 2019 99.9%
Kevin Hines Individual W-2 Managing EmployeeAdministrator Aug 30, 2019 100%
Kathleen Marie Dempsey Individual W-2 Managing EmployeeAdministrator Oct 11, 2019 100%
Shaun Ahmad Individual Corporate OfficerPresident Aug 30, 2019 100%

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1562889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562889600000",
    "number": "1205488947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13024 BALLANTYNE CORPORATE PL STE 425",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774420",
            "telephone_number": "704-426-8849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4314 S WABASH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606533119",
            "telephone_number": "773-538-8300",
            "fax_number": "773-538-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREATE CHICAGO OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-12",
        "last_updated": "2019-07-12",
        "status": "A",
        "authorized_official_last_name": "AHMAD",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "704-426-8849",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.