Axiom Healthcare of Mount Vernon LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

AXIOM HEALTHCARE OF MOUNT VERNON LLC

Practice address

1700 White St
Mount Vernon, IL 62864-4349

Phone

(618) 242-4075

NPI assigned

Sep 18, 2024

Organization subpart

No

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Asad U. Zaman, M.D.

  • Internal Medicine Physician
  • Tinley Park, IL
  • NPI 1780636944

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

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  CMS ownership
• Arcadia Care Havana LLC

  • Skilled Nursing Facility
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  • NPI 1962239475

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  CMS ownership
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  CMS ownership

Listed as

Axiom Healthcare of Mount VernonCCN 145517

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

1 of 5

Quality measures

1 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Feb 21, 1985

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6546.7 residents per day on average

Chain

Axiom Healthcare8 facilities in the chain

Abuse citation

Cited for abuse (Care Compare abuse icon)

Penalties (3 years)

11Fines totaling $355,763

Processed by Care Compare on Aug 1, 2026.

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Skilled nursing facility certification: CCN 145517

Legal name

AXIOM HEALTHCARE OF MOUNT VERNON LLC

Doing business as

AXIOM HEALTHCARE OF MOUNT VERNON

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Feb 21, 1985

Last certification

Dec 19, 2024

Beds

65

Ownership / control type

Corporation

Multi-facility organization

Petersen Healthcare

Organization structure

LLCProprietary

Enrollment address

1700 White St
Mount Vernon, IL 62864-4349

Nursing home name

AXIOM HEALTHCARE OF MOUNT VERNON

Affiliated entity

AXIOM HEALTHCARE

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

Tax ID family

Ability Network2 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.

• Axiom Healthcare of Mount Vernon LLC

  • Durable Medical Equipment & Medical Supplies
  • Mount Vernon, IL
  • NPI 1497582993
  NPD tax ID

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

Authorized official

Name

Jennifer Spector

Title

VP of Revenue Cycle Management

Phone

(847) 262-3800

Specialties & licenses 1

Addresses

Other names 1

• Axiom Healthcare Of Mount Vernon Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762214400000",
    "number": "1225865728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 W CHASE AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121605",
            "telephone_number": "847-262-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 WHITE ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628644349",
            "telephone_number": "618-242-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXIOM HEALTHCARE OF MOUNT VERNON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-18",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A",
        "authorized_official_last_name": "SPECTOR",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "VP OF REVENUE CYCLE MANAGEMENT",
        "authorized_official_telephone_number": "847-262-3800"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Axiom Healthcare Of Mount Vernon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Mount Vernon, IL
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; 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.