NPIMap

Organization Active NPI

Gottlieb Memorial Hospital

  • Skilled Nursing Facility
  • Melrose Park, IL
National Provider Identifier
1366555245
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0005561 Issued in IL
Legal business name
GOTTLIEB MEMORIAL HOSPITAL
Practice address
701 W North Ave
Melrose Park, IL 60160-1612
Phone
(708) 681-3200
Fax
(708) 450-5058
NPI assigned
Aug 16, 2006
Last updated
Jun 2, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
GOTTLIEB MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Authorized official

Name
Mrs. Elizabeth Early
Title
President
Phone
(708) 538-6920

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0005561 IL Primary

Addresses

Primary practice location

701 W North Ave
Melrose Park, IL 60160-1612

Mailing address

701 W North Ave
Melrose Park, IL 60160-1612
Phone (708) 681-3200

Other identifiers 1

IdentifierTypeStateIssuer
0741OtherILBLUE CROSS

Other names 1

  • GOTTLIEB MEMORIAL HOSPITAL TCU Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080910000658 IL Part A Provider - Skilled Nursing Facility 9234156233 Practice locations: Melrose Park, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366555245. Details of each certification follow.

Skilled nursing facility certification: CCN 145526

Legal name
GOTTLIEB MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 10, 1985
Last certification
Mar 7, 2024
Beds
32
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Trinity Health
Organization structure
CorporationNon-profit
Incorporated
Aug 8, 1956 in IL
Enrollment address
701 W North Ave
Melrose Park, IL 60160-1612
Nursing home name
GOTTLIEB MEMORIAL HOSPITAL
Affiliated entity
TRINITY HEALTH

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Gottlieb Memorial HospitalCCN 145526 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jun 10, 1985
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
3223.2 residents per day on average
Chain
Trinity Health19 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Gottlieb Mem Medical SE5 organizations share this tax ID, including this one
Part of
Gottlieb Mem Medical SE

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

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.

NameRoleSinceShare
Antoinette M Pratt Individual Operational/Managerial ControlChain Home Office Administrator Jul 1, 2019
Elizabeth Early Individual Corporate OfficerPresident Dec 18, 2020
Corporate DirectorBoard Member Dec 18, 2020
W-2 Managing Employee Dec 18, 2020
Eva Maria Wojcik Individual Corporate DirectorDirector Sep 23, 2022
Melissa Lukasick Individual Corporate OfficerCfo/Treasurer Jun 28, 2019
Richard K Freeman Individual Corporate OfficerChief Medical Officer Dec 18, 2020
Marc H Schwartz Individual Corporate OfficerChairman of Board Oct 3, 2014
Maria J Pekar Individual Corporate OfficerAssistant Secretary Dec 14, 2012
Joy V Cunningham Individual Corporate DirectorBoard Member Jan 1, 2013
Jill Rappis Individual Corporate OfficerSecretary Jul 8, 2011
Lori T Healey Individual Corporate DirectorBoard Member Jan 1, 2013
Adenrele Adekunbi Kolawole Individual Corporate OfficerDirector Central Billing Operations Sep 27, 2019
Loyola University Health System Organization, Maywood, IL Non-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2008 100%
Trinity Health Corporation Organization, Livonia, MI Holding company 5% Or Greater Indirect Ownership Interest Jul 1, 2011 100%
Tad Gomez Individual Corporate DirectorBoard Member Jan 1, 2022
Pierre Monice Individual Corporate DirectorBoard Member Jan 1, 2022

Owners & managing parties with NPI records 2

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

Facilities with the same owner 157

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

View all 157

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748822400000",
    "number": "1366555245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601612",
            "telephone_number": "708-681-3200",
            "fax_number": "708-450-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601612",
            "telephone_number": "708-681-3200",
            "fax_number": "708-450-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOTTLIEB MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GOTTLIEB MEMORIAL HOSPITAL",
        "enumeration_date": "2006-08-16",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A",
        "authorized_official_last_name": "EARLY",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-538-6920",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0005561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0741",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GOTTLIEB MEMORIAL HOSPITAL TCU",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Melrose Park, IL

Sources for this page

Verify at the official NPI Registry.