Alden-Lincoln Park Rehabilitation and Health Care Center, Inc.
Organization Active NPI Skilled Nursing Facility · Chicago, IL
NPI 1336136803 · NPPES record last updated Jun 28, 2010
Key facts
- NPI
- 1336136803
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 0040709 (IL)
- Legal business name
- ALDEN-LINCOLN PARK REHABILITATION AND HEALTH CARE CENTER, INC.
- Practice address
- 504 W Wellington Ave
Chicago, IL 60657-5421 - Phone
- (773) 281-6200
- Fax
- (773) 281-5623
- NPI assigned
- Sep 30, 2005
- Organization subpart
- No
Authorized official
- Name
- Floyd A Schlossberg
- Title
- President
- Phone
- (773) 286-6622
Corporate family (same tax ID) 1
Facilities with the same owner 28
Affiliated clinicians 1
-
Maher Al-Koubaytari, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Alden Lincoln Rehab & H C Ctr
- Overall star rating
- ★★★☆☆ 3 of 5
- Health inspections
- ★★★☆☆ 3 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★★☆☆☆ 2 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Feb 6, 1967
- Medicare certification status
- Active
- Certified beds
- 96 · 83.0 residents per day on average
- Chain
- The Alden Network
- Penalties (3 years)
- 2 · fines totaling $8,512
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Skilled nursing facility certification: CCN 145126
- Legal name
- ALDEN-LINCOLN PARK REHABILITATION AND HEALTH CARE CENTER, INC.
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Feb 6, 1967
- Last certification
- Jul 25, 2024
- Beds
- 96
- Ownership / control type
- Corporation
- Multi-facility organization
- Alden Managment Services
- Organization structure
- Corporation · Proprietary
- Incorporated
- Feb 9, 1995 in IL
- Enrollment address
- 504 West Wellington Ave
Chicago, IL 60657-5421 - Nursing home name
- ALDEN LINCOLN REHAB & H C CTR
- Affiliated entity
- THE ALDEN NETWORK
All disclosed owners & managing parties 18
| Name | Role | Since | Share |
|---|---|---|---|
| Mary P Saleh |
W-2 Managing Employee |
Jun 30, 2014 | 100% |
| Arin G Elisco |
5% Or Greater Indirect Ownership Interest | Jul 1, 2013 | 6.26% |
| Garrett E Magnusson |
5% Or Greater Indirect Ownership Interest | Jul 1, 2013 | 6.26% |
| Joan P Carl |
Corporate Officer | Feb 9, 1995 | |
| Corporate Director | Feb 9, 1995 | ||
| Alden Management Services, Inc. |
Operational/Managerial Control | Feb 9, 1995 | 100% |
| Randi Schullo Grantor TR Dated 11/02/2004 |
5% Or Greater Indirect Ownership Interest | Feb 28, 2018 | 20.77% |
| Joseph Schullo |
5% Or Greater Indirect Ownership Interest | Jul 1, 2013 | 6.26% |
| Robert J Molitor |
Operational/Managerial Control |
Jun 16, 2008 | |
| Lauren Magnusson Grantor TR Dated 11/02/2004 |
5% Or Greater Indirect Ownership Interest | Feb 28, 2018 | 20.77% |
| The Alden Group, LTD. |
5% Or Greater Direct Ownership Interest | Feb 13, 2008 | 100% |
| Paige a Magnusson |
5% Or Greater Indirect Ownership Interest | Jul 1, 2013 | 6.26% |
| Nicole Schullo |
5% Or Greater Indirect Ownership Interest | Jul 1, 2013 | 6.26% |
| Margo Marasa |
Operational/Managerial Control |
Sep 12, 2011 | |
| Randi Schullo |
5% Or Greater Indirect Ownership Interest | Jul 1, 2013 | 20.77% |
| Corporate Officer | Feb 16, 2010 | ||
| Charles L Elisco |
5% Or Greater Indirect Ownership Interest | Jul 1, 2013 | 6.26% |
| Midcap Funding IV Trust |
5% Or Greater Security Interest | Jul 1, 2010 | 29% |
| Floyd a Schlossberg |
Corporate Officer | Feb 9, 1995 | |
| Corporate Director | Feb 9, 1995 | ||
| Audra Elisco Grantor TR Dated 11/02/2004 |
5% Or Greater Indirect Ownership Interest | Mar 1, 2018 | 20.77% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110105000085 | IL | Part a Provider - Skilled Nursing Facility | 3971792052 | Practice locations: Chicago, IL |
National Provider Directory
- Tax ID family
- Alden Lincoln Park Rehab and Health Care Center Inc
Locations
4200 W Peterson Ave
Ste 140
Chicago, IL 60646
Phone (773) 286-6622
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0040709 | IL | Yes |
Addresses
Primary practice location
504 W Wellington Ave
Chicago, IL 60657-5421
Mailing address
4200 W Peterson Ave
Suite 140
Chicago, IL 60646-6074
Phone (772) 286-6622
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1116 | Other | IL | BLUE CROSS |
Other providers in Chicago, IL
- Alden Princeton Rehabilitation and Health Care Center, Inc.
- Alden Town Manor
- Alden Village North, Inc.
- Alden Village North, Inc.
- Alden-Lakeland Rehabilitation and Health Care Center, Inc.
- Alden-Northmoor Rehabilitation and Health Care Center, Inc.
- Alden-Princeton Rehabilitation and Health Care Center, Inc.
- Alden-Wentworth Rehabilitation and Health Care Center, Inc.
- Alison Rose Alden
- Carrie A Alden
All providers in Chicago, IL · Skilled Nursing Facility in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.