Lake Forest Place, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

LAKE FOREST PLACE, LLC

Practice address

1100 Pembridge Dr
Lake Forest, IL 60045-4228

Phone

(847) 604-6700

Fax

(847) 979-3969

NPI assigned

Dec 22, 2015

Organization subpart

No

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

Authorized official

Name

Mark Havrilka

Title

Chief Financial Officer

Phone

(847) 979-3904

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Skilled nursing facility certification: CCN 145986

Legal name

LAKE FOREST PLACE, LLC

Certification status

Active

Provider type (POS)

Nursing home – SNF (Medicare) only

Participating since

Sep 23, 1999

Last certification

Dec 12, 2024

Beds

50

Ownership / control type

Nonprofit Corporation

Multi-facility organization

Presterterian Homes

Most recent change of ownership

Dec 1, 2015

Organization structure

LLCNon-profit

Incorporated

Oct 28, 2014 in IL

Enrollment address

1101 Pembridge Dr
Lake Forest, IL 60045-4222

Nursing home name

LAKE FOREST PLACE

Listed as

Lake Forest PlaceCCN 145986

Overall star rating

5 of 5

Health inspections

4 of 5

Staffing

5 of 5

Quality measures

3 of 5

Type

Medicare

Ownership

Non profit - Corporation

Certified

Sep 23, 1999

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

5047.4 residents per day on average

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 30

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

Owners & managing parties with NPI records 1

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

• Anna Breen Liggett, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Chicago, IL
  • NPI 1548618549

  Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 2

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

• The Moorings of Arlington Heights, LLC

  • Skilled Nursing Facility
  • Arlington Heights, IL
  • NPI 1326403106

  Presbyterian Homes, Presbyterian Homes Manager LLC

  CMS ownership
• Westminster Place

  • Skilled Nursing Facility
  • Evanston, IL
  • NPI 1750351425

  Presbyterian Homes, Presbyterian Homes Manager LLC

  CMS ownership

Affiliated clinicians 10

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

• Jason T Garti, M.D.

  • Internal Medicine Physician
  • Lake Forest, IL
  • NPI 1003890500

  Nursing home

  Care Compare affiliation
• Eliana Geller

  • Geriatric Medicine (Internal Medicine) Physician
  • Chicago, IL
  • NPI 1053816280

  Nursing home

  Care Compare affiliation
• Mark A Greenberger, M.D.

  • Internal Medicine Physician
  • Highland Park, IL
  • NPI 1174555742

  Nursing home

  Care Compare affiliation
• Marina Kovacevic, MD

  • Hospitalist Physician
  • Evanston, IL
  • NPI 1881099596

  Nursing home

  Care Compare affiliation
• Steven Matthew Lasin, MD

  • Internal Medicine Physician
  • Lake Forest, IL
  • NPI 1477574945

  Nursing home

  Care Compare affiliation
• Anna Breen Liggett, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Chicago, IL
  • NPI 1548618549

  Nursing home

  Care Compare affiliation
• John J Munsell, M.D.

  • Internal Medicine Physician
  • Lake Bluff, IL
  • NPI 1700893153

  Nursing home

  Care Compare affiliation
• Brent M Nathan, MD

  • Internal Medicine Physician
  • Bannockburn, IL
  • NPI 1639559719

  Nursing home

  Care Compare affiliation
• Gerald Jay Osher, M.D.

  • Internal Medicine Physician
  • Bannockburn, IL
  • NPI 1326056136

  Nursing home

  Care Compare affiliation
• David A. Smiley, M.D.

  • Internal Medicine Physician
  • Highland Park, IL
  • NPI 1316974538

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1450742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633651200000",
    "number": "1336504117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 PEMBRIDGE DR",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600454228",
            "telephone_number": "847-437-6700",
            "fax_number": "847-316-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 PEMBRIDGE DR",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600454228",
            "telephone_number": "847-604-6700",
            "fax_number": "847-979-3969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE FOREST PLACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-22",
        "last_updated": "2021-10-08",
        "certification_date": "2020-09-09",
        "status": "A",
        "authorized_official_last_name": "HAVRILKA",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "847-979-3904"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Forest Integrated
• Lake Forest Medical SC
• Lake Forest Obstetrics Gynecology & Infertility S.C.
• Lake Forest Pediatic Dentistry, PC
• Lake Forest Pediatric Associates, LTD
• Lake Forest Plastic Surgery LTD.
• Lake Forest Regenesis Medical Center, PLLC
• Lake Forest School District 67
• Lake Shore Pediatrics, LTD
• Christopher R. Lang, MD

• Skilled Nursing Facility in Lake Forest, IL
• Providers in Lake Forest, 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 Oct 8, 2021; 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.