Organization Active NPI

Brookdale Living Communities of Illinois - DNC, LLC

Doing business as Brookdale Plaza Lisle SNF

  • Skilled Nursing Facility
  • Lisle, IL
National Provider Identifier
1407805096
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0042226 Issued in IL
Legal business name
BROOKDALE LIVING COMMUNITIES OF ILLINOIS - DNC, LLC
Doing business as
Brookdale Plaza Lisle SNF
Practice address
1800 Robin LN
Lisle, IL 60532-2086
Phone
(630) 810-0500
NPI assigned
May 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Authorized official

Name
Anna F.C. Munoz
Title
Assistant Secretary
Phone
(414) 918-5443

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0042226 IL Primary

Addresses

Primary practice location

1800 Robin LN
Lisle, IL 60532-2086

Mailing address

1800 Robin LN
Suite 1400
Lisle, IL 60532-2086
Phone (630) 810-0500

Other names 1

  • Brookdale Plaza Lisle SNF Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031016000002 IL Part A Provider - Skilled Nursing Facility 2365354230 Practice locations: Lisle, IL

Skilled nursing facility certification: CCN 146061

Legal name
BROOKDALE LIVING COMMUNITIES OF ILLINOIS - DNC, LLC
Doing business as
BROOKDALE PLAZA LISLE SNF
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Feb 23, 2004
Last certification
Sep 20, 2024
Beds
82 (55 certified)
Ownership / control type
Corporation
Multi-facility organization
brookdale lisle
Organization structure
LLCProprietary
Enrollment address
1800 Robin LN
Lisle, IL 60532-2086

Care Compare: Nursing home

Medicare Care Compare
Listed as
The Commons at Lisle Creek EstatesCCN 146061 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Feb 23, 2004
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5547.7 residents per day on average
Penalties (3 years)
1Fines totaling $10,059

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2045852Brookdale Plaza - Lisle1800 Robin LN, Lisle, IL 60532Certificate of waiverAug 20, 2026

National Provider Directory

National Provider Directory

Locations

1800 Robin Ln
Ste 1400
Lisle, IL 60532

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Kevin W Bowman Individual Corporate OfficerVice President - Accounting Jan 22, 2017
Operational/Managerial Control Jan 22, 2017
Ryan Stephenitch Individual Operational/Managerial Control Jul 2, 2025
Kevin W la Marre Individual Corporate OfficerVice President-Accounting Jan 22, 2017
Ventas LP Realty, LLC Organization, Chicago, IL LLC Adp of the SNF Jan 16, 2026
Francisco J Guajardo Individual Operational/Managerial Control Feb 21, 2022
Adp of the SNF Jan 16, 2026
Brookdale Senior Living Inc Organization, Brentwood, TN Corporation, Holding company, Chain home office 5% Or Greater Indirect Ownership Interest Jun 28, 2008 100%
Chadwick C White Individual Operational/Managerial Control Mar 9, 2018
Managing Control - Governing BodyExecutive Vice President & Secre Mar 9, 2018
Individual Adp of the SNF Jul 2, 2025
Henry Todd Kaestner Individual Managing Control - Governing BodyExecutive Vice President & Secre Mar 21, 2022
Brookdale Living Communities Inc. Organization, Brentwood, TN Corporation, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jul 30, 1999 100%
Lucinda M Baier Individual Managing Control - Governing BodyPresident/Ceo Manager Mar 9, 2018
Ventas, Inc. Organization, Chicago, IL Corporation Adp of the SNF Feb 1, 2009
Jawwad Hussain Individual Operational/Managerial Control May 9, 2024
Adp of the SNF Jan 16, 2026
LBMC PC Organization, Brentwood, TN Corporation Adp of the SNF Jan 1, 2024
Anna F.C. Munoz Individual Corporate OfficerAssistant Secretary Feb 15, 2024
Operational/Managerial Control Feb 15, 2024
Nikolas W Stengle Individual Operational/Managerial Control Nov 8, 2025
Managing Control - Governing BodyChief Executive Officer Manager Nov 1, 2024
Individual Direct Ownership Interest Jun 1, 2002 5.34%
Individual Direct Ownership Interest Jun 1, 2023 5.34%
Dawn Kussow Individual Operational/Managerial Control Jul 23, 2024
Walters Financial Services Inc Organization, Sarasota, FL Corporation, Consulting firm Adp of the SNF Jul 2, 2025
Ventas Realty Limited Partnership Organization, Louisville, KY Adp of the SNF Feb 1, 2019

Owners & managing parties with NPI records 1

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

Facilities with the same owner 7

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

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740441600000",
    "number": "1407805096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 ROBIN LN",
            "address_2": "SUITE 1400",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605322086",
            "telephone_number": "630-810-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 ROBIN LN",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605322086",
            "telephone_number": "630-810-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKDALE LIVING COMMUNITIES OF ILLINOIS - DNC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A",
        "authorized_official_last_name": "MUNOZ",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "F.C.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "414-918-5443"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0042226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Plaza Lisle SNF",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lisle, IL

Sources for this page

Verify at the official NPI Registry.