Pavilion on Main Street LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PAVILION ON MAIN STREET LLC

Doing business as

Pavilion on Main Street

Practice address

515 N Main St
Sandwich, IL 60548-1253

Phone

(815) 786-8426

Fax

(815) 786-6487

NPI assigned

May 24, 2022

Last updated

Nov 4, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marcella Graf

Title

Cfo

Phone

(224) 470-2044

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pavilion on Main Street Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366180903. Details of each certification follow.

• CCN 145712 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 145712

Legal name

PAVILION ON MAIN STREET LLC

Doing business as

PAVILION ON MAIN STREET

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF distinct part

Participating since

Mar 1, 1992

Last certification

Oct 30, 2024

Beds

116 (113 certified)

Ownership / control type

Individual

Organization structure

PartnershipProprietary

Enrollment address

515 N Main St
Sandwich, IL 60548-1253

Nursing home name

PAVILION ON MAIN STREET, THE

Affiliated entity

PAVILION HEALTHCARE

Listed as

Pavilion on Main Street, theCCN 145712 · All quality measures

Overall star rating

3 of 5

Health inspections

3 of 5

Staffing

2 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Individual

Certified

Mar 1, 1992

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

11391.6 residents per day on average

Chain

Pavilion Healthcare5 facilities in the chain

Penalties (3 years)

4Fines totaling $93,883

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 15

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.

• Jason C. Robin, MD

  • Cardiovascular Disease Physician
  • Glenview, IL
  • NPI 1144307729

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 24

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

• Citadel at Casa Scalabrini LLC

  dba Citadel at Casa Scalabrini

  • Skilled Nursing Facility
  • Northlake, IL
  • NPI 1023859048

  Todd a Stern 2015 Irrv Ins TR

  CMS ownership
• Citadel at Saint Benedict LLC

  dba Citadel at Saint Benedict

  • Skilled Nursing Facility
  • Niles, IL
  • NPI 1467293480

  Todd a Stern 2015 Irrv Ins TR

  CMS ownership
• Citadel Care Center-Kankakee, LLC

  dba Citadel Care Center-Kankakee

  • Skilled Nursing Facility
  • Kankakee, IL
  • NPI 1649648833

  Stern Family Investment TR

  CMS ownership
• Citadel Care Center-Wilmette, LLC

  dba Citadel Care Center-Wilmette

  • Skilled Nursing Facility
  • Wilmette, IL
  • NPI 1366810558

  Stern Family Investment TR

  CMS ownership
• Citadel of Bourbonnais LLC

  dba The Citadel of Bourbonnais

  • Skilled Nursing Facility
  • Bourbonnais, IL
  • NPI 1710594353

  Todd a Stern 2015 Irrv Ins TR

  CMS ownership
• Citadel of Glenview LLC

  dba The Citadel of Glenview

  • Skilled Nursing Facility
  • Glenview, IL
  • NPI 1902413537

  Todd a Stern 2015 Irrv Ins TR

  CMS ownership
• Citadel of Skokie LLC

  dba The Citadel of Skokie

  • Skilled Nursing Facility
  • Skokie, IL
  • NPI 1093354078

  Stern Family Investment TR

  CMS ownership
• Ignite Medical Hanover Park, LLC

  • Skilled Nursing Facility
  • Hanover Park, IL
  • NPI 1932899689

  Stern Family Investment TR

  CMS ownership
• Pavilion of Bridgeview LLC

  dba Pavilion of Bridgeview

  • Skilled Nursing Facility
  • Bridgeview, IL
  • NPI 1316685969

  Ilana D Aaron Trust C/U Maurice Aaron 2014 Family Gift Trust, Ilana D Aaron Trust C/U Maurice Aaron 2014 Legacy Gift Trust, Stern Family Investment TR, Todd a Stern 2015 Irrv Ins TR

  CMS ownership
• Pavilion of Logan Square LLC

  dba Pavilion of Logan Square

  • Skilled Nursing Facility
  • Chicago, IL
  • NPI 1588302137

  Ilana D Aaron Trust C/U Maurice Aaron 2014 Family Gift Trust, Ilana D Aaron Trust C/U Maurice Aaron 2014 Legacy Gift Trust, Stern Family Investment TR, Todd a Stern 2015 Irrv Ins TR

  CMS ownership
• Pavilion of Ottawa LLC

  dba Pavilion of Ottawa

  • Skilled Nursing Facility
  • Ottawa, IL
  • NPI 1306584958

  Emst LLC, Ilana D Aaron Trust C/U Maurice Aaron 2014 Family Gift Trust, Ilana D Aaron Trust C/U Maurice Aaron 2014 Legacy Gift Trust, Jonathan H Aaron Revocable Trust, Stern Family Investment TR, Todd a Stern 2015 Irrv Ins TR

  CMS ownership
• Pavilion of South Shore LLC

  dba Pavilion of South Shore

  • Skilled Nursing Facility
  • Chicago, IL
  • NPI 1922746577

  Ilana D Aaron Trust C/U Maurice Aaron 2014 Family Gift Trust, Ilana D Aaron Trust C/U Maurice Aaron 2014 Legacy Gift Trust, Jonathan H Aaron Revocable Trust, Stern Family Investment TR, Todd a Stern 2015 Irrv Ins TR

  CMS ownership

Affiliated clinicians 2

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

• Erik David Englehart, M.D.

  • Family Medicine Physician
  • Sandwich, IL
  • NPI 1679581367

  Nursing home

  Care Compare affiliation
• Ravinderpal Singh Nandra, M.D.

  • Internal Medicine Physician
  • Plano, IL
  • NPI 1639358427

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762214400000",
    "number": "1366180903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3755 CHASE AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600764008",
            "telephone_number": "224-470-2044",
            "fax_number": "224-470-2952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 N MAIN ST",
            "city": "SANDWICH",
            "state": "IL",
            "postal_code": "605481253",
            "telephone_number": "815-786-8426",
            "fax_number": "815-786-6487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAVILION ON MAIN STREET LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-24",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A",
        "authorized_official_last_name": "GRAF",
        "authorized_official_first_name": "MARCELLA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "224-470-2044"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6008379",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Pavilion on Main Street",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah R Nourzad, LCSW
• Emily Catherine Ochoa, APRN, CNP
• Leslie Ann Oliver, CNM, APRN
• Open Door Rehabilitation Center
• Jill M Palko, M.D.
• Peace & Consolation Counseling LLC
• Pediatric Home Therapy
• Jennifer Lynn Pellicano, PSYD
• Petersen Health Business, LLC (Sandwich Rehabilitation & Health Care Center)
• Audrey Peterson, ALMFT

• Skilled Nursing Facility in Sandwich, IL
• Providers in Sandwich, 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 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.