Active NPI
Brookdale Living Communities of Illinois - DNC, LLC
Doing business as Brookdale Plaza Lisle SNF
- Skilled Nursing Facility
- Lisle, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 0042226
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- LLC
- Enrollment address
- 1800 Robin LN
Lisle, IL 60532-2086
Care Compare: Nursing home
Medicare Care Compare- Listed as
- The Commons at Lisle Creek Estates
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Feb 23, 2004
- Medicare certification status
- Active
- Certified beds
- 55
- Penalties (3 years)
- 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2045852 | Brookdale Plaza - Lisle | Certificate of waiver | Aug 20, 2026 |
National Provider Directory
National Provider DirectoryLocations
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Kevin W Bowman | Corporate Officer | Jan 22, 2017 | |
| Operational/Managerial Control | Jan 22, 2017 | ||
| Ryan Stephenitch | Operational/Managerial Control | Jul 2, 2025 | |
| Kevin W la Marre | Corporate Officer | Jan 22, 2017 | |
| Ventas LP Realty, LLC | Adp of the SNF | Jan 16, 2026 | |
| Francisco J Guajardo | Operational/Managerial Control | Feb 21, 2022 | |
| Adp of the SNF | Jan 16, 2026 | ||
| Brookdale Senior Living Inc | 5% Or Greater Indirect Ownership Interest | Jun 28, 2008 | 100% |
| Chadwick C White | Operational/Managerial Control | Mar 9, 2018 | |
| Managing Control - Governing Body | Mar 9, 2018 | ||
| Adp of the SNF | Jul 2, 2025 | ||
| Henry Todd Kaestner | Managing Control - Governing Body | Mar 21, 2022 | |
| Brookdale Living Communities Inc. | 5% Or Greater Direct Ownership Interest | Jul 30, 1999 | 100% |
| Lucinda M Baier | Managing Control - Governing Body | Mar 9, 2018 | |
| Ventas, Inc. | Adp of the SNF | Feb 1, 2009 | |
| Jawwad Hussain | Operational/Managerial Control | May 9, 2024 | |
| Adp of the SNF | Jan 16, 2026 | ||
| LBMC PC | Adp of the SNF | Jan 1, 2024 | |
| Anna F.C. Munoz | Corporate Officer | Feb 15, 2024 | |
| Operational/Managerial Control | Feb 15, 2024 | ||
| Nikolas W Stengle | Operational/Managerial Control | Nov 8, 2025 | |
| Managing Control - Governing Body | Nov 1, 2024 | ||
| Direct Ownership Interest | Jun 1, 2002 | 5.34% | |
| Direct Ownership Interest | Jun 1, 2023 | 5.34% | |
| Dawn Kussow | Operational/Managerial Control | Jul 23, 2024 | |
| Walters Financial Services Inc | Adp of the SNF | Jul 2, 2025 | |
| Ventas Realty Limited Partnership | 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.
-
- Family Medicine Physician
- Oakbrook Terrace, IL
- NPI 1336434935
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 7
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Brookdale Greenwood Village
- Skilled Nursing Facility
- Greenwood Village, CO
- NPI 1326006297
Brookdale Senior Living Inc
-
dba Brookdale Santa Catalina
- Skilled Nursing Facility
- Tucson, AZ
- NPI 1689632770
Brookdale Senior Living Inc
-
dba Brookdale Rosehill
- Skilled Nursing Facility
- Shawnee, KS
- NPI 1710935069
Brookdale Senior Living Inc
-
dba Brookdale Westlake Village
- Skilled Nursing Facility
- Westlake, OH
- NPI 1083864854
Brookdale Senior Living Inc
-
dba Brookdale University Park SNF (AL)
- Skilled Nursing Facility
- Birmingham, AL
- NPI 1366700528
Brookdale Senior Living Inc
-
dba Brookdale Riverwalk SNF (CA)
- Skilled Nursing Facility
- Bakersfield, CA
- NPI 1275697658
Brookdale Senior Living Inc
-
dba Brookdale Palmer Ranch SNF
- Skilled Nursing Facility
- Sarasota, FL
- NPI 1225039605
Brookdale Senior Living Inc
Practitioners & affiliated clinicians
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Internal Medicine) Physician
- Burr Ridge, IL
- NPI 1023067311
Nursing home
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.