NPIMap

Organization Active NPI

Divine Hospice & Palliative Care LLC

Doing business as Delta Hospice & Palliative Care LLC

  • Community Based Hospice Care Agency
  • Yorkville, IL
National Provider Identifier
1437517547
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
DIVINE HOSPICE & PALLIATIVE CARE LLC
Doing business as
Delta Hospice & Palliative Care LLC
Practice address
234 Garden St
Yorkville, IL 60560-8921
Phone
(630) 553-8500
Fax
(888) 977-3195
NPI assigned
Feb 3, 2016
Last updated
Aug 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Authorized official

Name
Binu George
Title
Authorized Official
Phone
(630) 553-8500

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Community Based Hospice Care Agency 251G00000X Primary
Community Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LC1500X

Addresses

Primary practice location

234 Garden St
Yorkville, IL 60560-8921

Mailing address

234 Garden St
Yorkville, IL 60560-8921
Phone (630) 553-8500

Other names 1

  • Delta Hospice & Palliative Care LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160729001975 IL Part A Provider - Hospice 2062705957 Practice locations: Yorkville, IL
O20200603000906 IL Part B Supplier - Clinic/Group Practice 2062705957 Receives reassigned benefits from 3 practitioners
Practice locations: Yorkville, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1437517547. Details of each certification follow.

Hospice certification: CCN 141690

Legal name
DIVINE HOSPICE & PALLIATIVE CARE LLC
Doing business as
DIVINE HOSPICE & PALLIATIVE CARE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Mar 29, 2017
Last certification
Mar 29, 2017
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Oct 17, 2014 in IL
Enrollment address
234 Garden St
Yorkville, IL 60560-8921

Care Compare: Hospice

Medicare Care Compare
Listed as
Divine Hospice & Palliative Care LLCCCN 141690 · All quality measures
Ownership
For-Profit
Certified
Mar 29, 2017
Medicare certification status
ActiveFrom the Provider of Services file

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
14D2101391Divine Hospice and Palliative Care LLC234 Garden Street, Yorkville, IL 60560Certificate of waiverAug 31, 2027

National Provider Directory

National Provider Directory

Locations

900 Jorie Blvd
#58C
Oak Brook, IL 60523

900 Jorie Blvd
Ste 58C
Oak Brook, IL 60523
Phone (630) 590-3221

234 Garden St
Yorkville, IL 60560
Phone (630) 553-8500

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Divine Hospice & Palliative Care LLC Organization, Yorkville, IL LLC 5% Or Greater Direct Ownership Interest Oct 17, 2014 100%
Binu George Individual 5% Or Greater Direct Ownership Interest Jun 19, 2017 25%
Corporate Officer Jun 19, 2017
Corporate Director Jun 16, 2017
W-2 Managing Employee Jun 19, 2017
Operational/Managerial ControlCeo Jun 19, 2017
Sanjay a Thakkar Individual 5% Or Greater Direct Ownership Interest Jun 19, 2017 75%
Operational/Managerial Control Jun 19, 2017

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 11

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": "1454457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1437517547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 GARDEN ST",
            "city": "YORKVILLE",
            "state": "IL",
            "postal_code": "605608921",
            "telephone_number": "630-553-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 GARDEN ST",
            "city": "YORKVILLE",
            "state": "IL",
            "postal_code": "605608921",
            "telephone_number": "630-553-8500",
            "fax_number": "888-977-3195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE HOSPICE & PALLIATIVE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-03",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "BINU",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "630-553-8500"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Community Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Delta Hospice & Palliative Care LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yorkville, IL

Sources for this page

Verify at the official NPI Registry.