Pine Crest Health Care LLC
Organization Active NPI Skilled Nursing Facility · Hazel Crest, IL
NPI 1376840538 · NPPES record last updated Aug 8, 2017
Key facts
- NPI
- 1376840538
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- PINE CREST HEALTH CARE LLC
- Practice address
- 3300 175TH St
Hazel Crest, IL 60429-1604 - Phone
- (708) 335-2400
- Fax
- (708) 335-1825
- NPI assigned
- Feb 23, 2011
- Organization subpart
- No
Authorized official
- Name
- Ms. Frances Meehan
- Title
- Attorney
- Phone
- (312) 521-2467
Owners & managing parties with NPI records 1
Facilities with the same owner 40
Affiliated clinicians 1
-
John M Curtin, DO
Medicare Care Compare: Nursing home
- Listed as
- Pine Crest Health Care
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★★★☆☆ 3 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Partnership
- Certified
- Dec 1, 1979
- Medicare certification status
- Active
- Certified beds
- 199 · 152.0 residents per day on average
- Chain
- Icare Consulting Services
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
- Penalties (3 years)
- 7 · fines totaling $197,290
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D0701843 | Pine Crest Health Care L L C | Certificate of waiver | Jan 28, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Skilled nursing facility certification: CCN 145220
- Legal name
- PINE CREST HEALTH CARE LLC
- Doing business as
- PINE CREST HEALTH CARE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Dec 1, 1979
- Last certification
- Sep 20, 2024
- Beds
- 199
- Ownership / control type
- Partnership
- Organization structure
- LLC · Proprietary
- Enrollment address
- 3300 175TH St
Hazel Crest, IL 60429-1604 - Nursing home name
- PINE CREST HEALTH CARE
- Affiliated entity
- ICARE CONSULTING SERVICES
All disclosed owners & managing parties 7
| Name | Role | Since | Share |
|---|---|---|---|
| Shimon Webster |
5% Or Greater Direct Ownership Interest | Jun 1, 2010 | 17% |
| Corporate Director | Jun 1, 2010 | 100% | |
| Operational/Managerial Control | Jun 1, 2010 | 100% | |
| Jeffrey J Webster |
5% Or Greater Direct Ownership Interest |
Jun 1, 2010 | 8% |
| Yeruchom Levovitz |
5% Or Greater Direct Ownership Interest | Jun 1, 2010 | 15% |
| Atied Associates LLC |
5% Or Greater Direct Ownership Interest | Jun 1, 2010 | 40% |
| Operational/Managerial Control | Dec 21, 2020 | ||
| Howard L Wengrow |
5% Or Greater Direct Ownership Interest | Jun 1, 2010 | 10% |
| David Zaruba |
W-2 Managing Employee |
Mar 14, 2020 | |
| Oak Park Oasis LLC |
Operational/Managerial Control | Dec 21, 2020 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110912000554 | IL | Part a Provider - Skilled Nursing Facility | 5092999581 | Practice locations: Hazel Crest, IL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
3300 175TH St
Hazel Crest, IL 60429-1604
Mailing address
3300 175TH St
Hazel Crest, IL 60429-1604
Phone (708) 335-2400
Other names
- Pine Crest Health Care
Other providers in Hazel Crest, IL
- Physical Therapy and Sports Injury Rehabilitation
- Physical Therapy and Sports Injury Rehabilitation, LTD
- Physicians Community Medical Center Hazel Crest,S.C.
- Rachel E Piepenbrink
- Constance Agnes Pietrzak
- Pinhas Sharon, MD LLC
- Fulton Porter III
- Tamara Lynn Powers
- Prakash G Sane MD SC
- Prescriptive Wellness LLC
All providers in Hazel Crest, 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 Aug 8, 2017. 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.