NPIMap

Organization Active NPI

Lakewood Nursing and Rehabilitation Center, LLC

  • Skilled Nursing Facility
  • Plainfield, IL
National Provider Identifier
1407971716
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0046169 Issued in IL
Legal business name
LAKEWOOD NURSING AND REHABILITATION CENTER, LLC
Practice address
14718 S Eastern Ave
Plainfield, IL 60544-8870
Phone
(815) 436-3400
Fax
(815) 436-8394
NPI assigned
Mar 20, 2007
Last updated
Aug 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Authorized official

Name
Mrs. Levi Israel
Title
Ceo
Phone
(847) 905-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0046169 IL Primary

Addresses

Primary practice location

14718 S Eastern Ave
Plainfield, IL 60544-8870

Mailing address

2201 Main St
Evanston, IL 60202-1519
Phone (847) 905-3000

Other identifiers 1

IdentifierTypeStateIssuer
50212OtherILBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080711000036 IL Part A Provider - Skilled Nursing Facility 4082524715 Practice locations: Plainfield, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407971716. Details of each certification follow.

Skilled nursing facility certification: CCN 145761

Legal name
LAKEWOOD NURSING AND REHABILITATION CENTER, LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 7, 1993
Last certification
Apr 3, 2025
Beds
131
Ownership / control type
Limited Liability Corporation
Most recent change of ownership
Jan 1, 2003
Organization structure
LLCProprietary
Incorporated
Oct 29, 2002 in IL
Enrollment address
14718 S Eastern Ave
Plainfield, IL 60544-8870
Nursing home name
LAKEWOOD NRSG & REHAB CENTER
Affiliated entity
EXTENDED CARE CLINICAL

Care Compare: Nursing home

Medicare Care Compare
Listed as
Lakewood NRSG & Rehab CenterCCN 145761 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jul 7, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
131112.7 residents per day on average
Chain
Extended Care Clinical9 facilities in the chain
Penalties (3 years)
1Fines totaling $55,201

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Kathryn Vales Accumulation Trust Organization, Evanston, IL Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2013 7.72%
Trustee of the SNF Jan 1, 2013
Ronald Paetsch Individual Operational/Managerial Control Jul 23, 2024
Adp of the SNF Jul 23, 2024
Straight Care Staffing Nursing Agency LLC Organization, Emmetsburg, IA LLC Adp of the SNF May 1, 2020
Melissa Rothner Accumulation Trust Organization, Evanston, IL Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2013 7.72%
Trustee of the SNF Jan 1, 2013
Kare Technologies LLC Organization, Houston, TX LLC Adp of the SNF May 1, 2020
Extended Care Clinical LLC Organization, Evanston, IL LLC Adp of the SNF Jan 1, 2015
Daniel Rothner Accumulation Trust Organization, Evanston, IL Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2013 7.72%
Trustee of the SNF Jan 1, 2013
Roth & Co, LLP Organization, Brooklyn, NY Adp of the SNF Jan 8, 2025
William Rothner Accumulation Trust Organization, Evanston, IL Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2013 7.75%
Trustee of the SNF Jan 1, 2013
Extended Care Consulting LLC Organization, Evanston, IL LLC Adp of the SNF Jan 1, 2015
Rothner Health Ventures G II, LLC Organization, Evanston, IL LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 1, 2013 100%
Adp of the SNF Jan 1, 2013
Srinivas C Kota Individual Operational/Managerial Control May 1, 2022
Adp of the SNF May 1, 2022
Rachel Rothner Accumulation Trust Organization, Evanston, IL Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2013 7.72%
Trustee of the SNF Jan 1, 2013
Kimberly Vales Accumulation Trust Organization, Evanston, IL Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2013 7.72%
Trustee of the SNF Jan 1, 2013
Adp of the SNF Jan 1, 2013
Nathan and Shirley Rothner Family Trust Organization, Evanston, IL Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2013 45.97%
Trustee of the SNF Jan 1, 2013
Adams Vales Accumulation Trust Organization, Evanston, IL Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2013 7.72%
Trustee of the SNF Jan 1, 2013
David Aronin Individual Corporate DirectorManager Jan 1, 2005
Levi Israel Individual Corporate OfficerCeo Jan 1, 2023

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 13

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

View all 13

Practitioners & affiliated clinicians

Affiliated clinicians 5

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": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1407971716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 MAIN ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021519",
            "telephone_number": "847-905-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14718 S EASTERN AVE",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605448870",
            "telephone_number": "815-436-3400",
            "fax_number": "815-436-8394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD NURSING AND REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A",
        "authorized_official_last_name": "ISRAEL",
        "authorized_official_first_name": "LEVI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "847-905-3000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0046169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "50212",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, IL

Sources for this page

Verify at the official NPI Registry.