Active NPI
Lacon Rehab and Nursing LLC
- Skilled Nursing Facility
- Lacon, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- LACON REHAB AND NURSING LLC
- Practice address
- 401 9TH St
Lacon, IL 61540-1140 - Phone
- (309) 246-2175
- Fax
- (309) 246-3609
- NPI assigned
- Apr 7, 2020
- Last updated
- Apr 7, 2020
- 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
- Chaim Millman
- Title
- Ceo
- Phone
- (845) 414-3300
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
401 9TH St
Lacon, IL 61540-1140
Mailing address
7B Medical Park Dr
Pomona, NY 10970-3516
Phone (845) 414-3300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6008999 | Medicaid | IL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | PCC | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200630000284 | IL | Part A Provider - Skilled Nursing Facility | 1254753700 | Practice locations: Lacon, IL |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1447889886. Details of each certification follow.
Skilled nursing facility certification: CCN 146123
- Legal name
- LACON REHAB AND NURSING LLC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 3, 2008
- Last certification
- May 23, 2025
- Beds
- 93
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Stern Consultants
- Most recent change of ownership
- Jul 15, 2020
- Organization structure
- LLC
- Incorporated
- Mar 27, 2020 in NY
- Enrollment address
- 401 9TH St
Lacon, IL 61540-1140 - Nursing home name
- LACON REHAB AND NURSING
- Affiliated entity
- STERN CONSULTANTS
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Lacon Rehab and Nursing
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jul 3, 2008
- Medicare certification status
- Active
- Certified beds
- 93
- Chain
- Stern Consultants
- Penalties (3 years)
- 3
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 |
|---|---|---|---|
| 14D2188355 | Lacon Rehab & Nursing, L L C | Certificate of waiver | Jul 15, 2028 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 23
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 |
|---|---|---|---|
| Boruch Sheps | 5% Or Greater Direct Ownership Interest | Jul 15, 2020 | 20% |
| Operational/Managerial Control | Jul 15, 2020 | 50% | |
| Managing Control - Governing Body | Jul 15, 2020 | ||
| Adp of the SNF | Jul 15, 2020 | ||
| Avraham Erblich | 5% Or Greater Direct Ownership Interest | Jul 15, 2020 | 10% |
| Operational/Managerial Control | Jul 15, 2020 | ||
| Managing Control - Governing Body | Jul 15, 2020 | ||
| Adp of the SNF | Jul 15, 2020 | ||
| Chaim Millman | 5% Or Greater Direct Ownership Interest | Jul 15, 2020 | 26% |
| Operational/Managerial Control | Jul 15, 2020 | 50% | |
| Managing Control - Governing Body | Jul 15, 2020 | ||
| Adp of the SNF | Jul 15, 2020 | ||
| Direct Ownership Interest | Jul 15, 2020 | 2.67% | |
| Indirect Ownership Interest | Jul 15, 2020 | 2.67% | |
| Benjamin Friedman | 5% Or Greater Direct Ownership Interest | Jul 15, 2020 | 13% |
| Operational/Managerial Control | Jul 15, 2020 | ||
| Managing Control - Governing Body | Jul 15, 2020 | ||
| Adp of the SNF | Jul 15, 2020 | ||
| Windy Cook | Operational/Managerial Control | Jul 15, 2020 | |
| Adp of the SNF | Jul 15, 2020 | ||
| Nimble Navigator Partners LLC | Adp of the SNF | Jan 11, 2021 | |
| Adp of the SNF | Jan 1, 2023 | ||
| Etn Family Holdings LLC | 5% Or Greater Direct Ownership Interest | Jul 15, 2020 | 13.5% |
| Adp of the SNF | Jan 11, 2021 | ||
| Lacon Propco One LLC | Adp of the SNF | Jan 11, 2021 | |
| Bezalel Stern | 5% Or Greater Direct Ownership Interest | Jul 15, 2020 | 13.5% |
| Adp of the SNF | Jan 11, 2021 | ||
| Adp of the SNF | Jan 1, 2023 | ||
| T Newhouse Family Trust | 5% Or Greater Indirect Ownership Interest | Jul 15, 2020 | 6.68% |
| Adp of the SNF | Jan 11, 2021 | ||
| Adp of the SNF | May 25, 2025 | ||
| Stanley Mathew | Operational/Managerial Control | Apr 1, 2025 | |
| Managing Control - Governing Body | Apr 1, 2025 | ||
| Adp of the SNF | Apr 1, 2025 | ||
| Eric Newhouse | Managing Control - Governing Body | Jul 15, 2020 | |
| Trustee of the SNF | Jul 15, 2020 | ||
| Indirect Ownership Interest | Jul 15, 2020 | 0.13% | |
| Andrea Plew | Operational/Managerial Control | Mar 10, 2020 | |
| Adp of the SNF | Mar 10, 2020 | ||
| Stern Therapy Consultants LLC | Operational/Managerial Control | Jul 15, 2020 | |
| Adp of the SNF | May 25, 2025 | ||
| Adp of the SNF | May 25, 2025 | ||
| Temi Newhouse | Trustee of the SNF | Jul 15, 2020 | |
| Direct Ownership Interest | Jul 15, 2020 | 1.33% | |
| Indirect Ownership Interest | Jul 15, 2020 | 1.33% | |
| Roxanne Dorsey | Operational/Managerial Control | Jan 11, 2023 | |
| Adp of the SNF | Jan 11, 2023 | ||
| E Newhouse Family Trust | 5% Or Greater Indirect Ownership Interest | Jul 15, 2020 | 6.68% |
| Adp of the SNF | Jan 11, 2021 |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Physical Medicine & Rehabilitation Physician
- Cedar Rapids, IA
- NPI 1003053653
Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control
-
- Physical Therapist
- Monsey, NY
- NPI 1073783544
5% Or Greater Direct Ownership Interest, Adp of the SNF
Facilities with the same owner 22
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Carmi, IL
- NPI 1174997316
E Newhouse Family Trust, T Newhouse Family Trust
-
- Skilled Nursing Facility
- Casey, IL
- NPI 1386471886
E Newhouse Family Trust, T Newhouse Family Trust
-
- Skilled Nursing Facility
- Charleston, IL
- NPI 1336003003
E Newhouse Family Trust, T Newhouse Family Trust
-
- Skilled Nursing Facility
- Macomb, IL
- NPI 1538996038
E Newhouse Family Trust, T Newhouse Family Trust
-
- Skilled Nursing Facility
- Ridgway, IL
- NPI 1497268783
E Newhouse Family Trust, T Newhouse Family Trust
-
- Skilled Nursing Facility
- Greenup, IL
- NPI 1952265639
E Newhouse Family Trust, Stern Therapy Consultants LLC, T Newhouse Family Trust
-
- Skilled Nursing Facility
- Henry, IL
- NPI 1336729672
E Newhouse Family Trust, Etn Family Holdings LLC, Stern Therapy Consultants LLC, T Newhouse Family Trust
-
- Skilled Nursing Facility
- Macomb, IL
- NPI 1871173112
E Newhouse Family Trust, Etn Family Holdings LLC, Stern Therapy Consultants LLC, T Newhouse Family Trust
-
- Skilled Nursing Facility
- Marshall, IL
- NPI 1801448816
Stern Therapy Consultants LLC
-
- Skilled Nursing Facility
- Mascoutah, IL
- NPI 1891594651
E Newhouse Family Trust, T Newhouse Family Trust
-
- Skilled Nursing Facility
- Aledo, IL
- NPI 1093370488
E Newhouse Family Trust, T Newhouse Family Trust
-
- Skilled Nursing Facility
- Monmouth, IL
- NPI 1194524975
E Newhouse Family Trust, T Newhouse Family Trust
Practitioners & affiliated clinicians
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Physical Medicine & Rehabilitation Physician
- Cedar Rapids, IA
- NPI 1003053653
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586217600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1586217600000",
"number": "1447889886",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7B MEDICAL PARK DR",
"city": "POMONA",
"state": "NY",
"postal_code": "109703516",
"telephone_number": "845-414-3300",
"fax_number": "845-517-4796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 9TH ST",
"city": "LACON",
"state": "IL",
"postal_code": "615401140",
"telephone_number": "309-246-2175",
"fax_number": "309-246-3609"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LACON REHAB AND NURSING LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-04-07",
"last_updated": "2020-04-07",
"certification_date": "2020-04-07",
"status": "A",
"authorized_official_last_name": "MILLMAN",
"authorized_official_first_name": "CHAIM",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "845-414-3300"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6008999",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "PCC",
"affiliation": "N",
"endpointDescription": "PointCLickCare",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "401 9th St",
"city": "Lacon",
"state": "IL",
"country_code": "US",
"postal_code": "615401140",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Lacon, IL
- Michael Douglas Girone, D.C.
- Jake A Griffin, PHARMD
- Michelle L Ho, P.T.
- Iowa Physicians Clinic Medical Foundation (Unitypoint Clinic Family Medicine - Lacon)
- John J Geiser O.D.
- Lacon Sparland Emergency 52 (Lacon Sparland Emergency Ambulance Service)
- Marshall County Health Department
- Beth Ann McKee, D.C.
- Methodist Medical Center of Illinois (Carle Health Lacon)
- Methodist Medical Center of Illinois (Methodist Medical Group at Lacon)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; 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.