NPIMap

Organization Active NPI

Generations at Applewood, LLC

  • Skilled Nursing Facility
  • Matteson, IL
National Provider Identifier
1407988413
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0046151 Issued in IL
Legal business name
GENERATIONS AT APPLEWOOD, LLC
Practice address
21020 Kostner Ave
Matteson, IL 60443-2068
Phone
(708) 747-1300
Fax
(708) 747-8540
NPI assigned
Mar 12, 2007
Last updated
Aug 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Authorized official

Name
Mr. Thomas Winter
Title
Cfo
Phone
(847) 675-7979

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0046151 IL Primary

Addresses

Primary practice location

21020 Kostner Ave
Matteson, IL 60443-2068

Mailing address

21020 Kostner Ave
Matteson, IL 60443-2068
Phone (708) 747-1300

Other identifiers 1

IdentifierTypeStateIssuer
50215OtherILBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110427000249 IL Part A Provider - Skilled Nursing Facility 3476738964 Practice locations: Matteson, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407988413. Details of each certification follow.

Skilled nursing facility certification: CCN 145781

Legal name
GENERATIONS AT APPLEWOOD, LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 22, 1993
Last certification
May 9, 2025
Beds
154
Ownership / control type
Limited Liability Corporation
Most recent change of ownership
Mar 1, 2011
Organization structure
LLCProprietary
Incorporated
Feb 7, 2011 in IL
Enrollment address
21020 Kostner Ave
Matteson, IL 60443-2068
Nursing home name
GENERATIONS AT APPLEWOOD
Affiliated entity
GENERATIONS HEALTHCARE NETWORK

Care Compare: Nursing home

Medicare Care Compare
Listed as
Generations at ApplewoodCCN 145781 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Dec 22, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
154128.9 residents per day on average
Chain
Generations Healthcare Network4 facilities in the chain
Penalties (3 years)
8Fines totaling $521,548

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Bryan Barrish Trust DTD 9/1/04 Organization, Lincolnwood, IL 5% Or Greater Direct Ownership Interest Mar 1, 2011 11.35%
Atied Associates LLC Organization, Evanston, IL 5% Or Greater Direct Ownership Interest Mar 1, 2011 30.6%
Barrish Group Limited Partnership Organization, Lincolnwood, IL 5% Or Greater Direct Ownership Interest Mar 1, 2011 11.35%
Ralph Gesualdo Individual 5% Or Greater Direct Ownership InterestPartner Mar 1, 2011 11.35%
Bryan Barrish Individual 5% Or Greater Direct Ownership InterestPresident of Manager Mar 1, 2011 11.35%
Ralph Gesualdo Childrens Trust Organization, Lake Forest, IL 5% Or Greater Direct Ownership Interest Mar 1, 2011 11.35%
Thomas Winter Individual Corporate Director Mar 1, 2011
Operational/Managerial Control Apr 1, 2020
Regina Ruiz Individual W-2 Managing EmployeeAdministrator Jan 27, 2020

Facilities with the same owner 41

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

View all 41

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": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659484800000",
    "number": "1407988413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21020 KOSTNER AVE",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604432068",
            "telephone_number": "708-747-1300",
            "fax_number": "708-747-8540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21020 KOSTNER AVE",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604432068",
            "telephone_number": "708-747-1300",
            "fax_number": "708-747-8540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERATIONS AT APPLEWOOD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A",
        "authorized_official_last_name": "WINTER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "847-675-7979",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0046151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "50215",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Matteson, IL

Sources for this page

Verify at the official NPI Registry.