Organization Active NPI

Lacon Rehab and Nursing LLC

  • Skilled Nursing Facility
  • Lacon, IL
National Provider Identifier
1447889886
Registry record updated Apr 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
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, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2020

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
6008999MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL PCC Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
LLCProprietary
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 NursingCCN 146123 · All quality measures
Overall star rating
2 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jul 3, 2008
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9357.2 residents per day on average
Chain
Stern Consultants22 facilities in the chain
Penalties (3 years)
3Fines totaling $40,740

Processed by Care Compare on Aug 1, 2026.

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
14D2188355Lacon Rehab & Nursing, L L C401 9TH St, Lacon, IL 61540Certificate of waiverJul 15, 2028

National Provider Directory

National Provider Directory

Ownership & 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.

NameRoleSinceShare
Boruch Sheps Individual 5% Or Greater Direct Ownership Interest Jul 15, 2020 20%
Operational/Managerial ControlCoo Jul 15, 2020 50%
Managing Control - Governing Body Jul 15, 2020
Adp of the SNF Jul 15, 2020
Avraham Erblich Individual 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 Individual 5% Or Greater Direct Ownership InterestCeo Jul 15, 2020 26%
Operational/Managerial ControlCeo Jul 15, 2020 50%
Managing Control - Governing Body Jul 15, 2020
Adp of the SNF Jul 15, 2020
Individual Direct Ownership Interest Jul 15, 2020 2.67%
Indirect Ownership Interest Jul 15, 2020 2.67%
Benjamin Friedman Individual 5% Or Greater Direct Ownership InterestCfo 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 Individual Operational/Managerial Control Jul 15, 2020
Adp of the SNF Jul 15, 2020
Nimble Navigator Partners LLC Organization, Clifton, NJ LLC Adp of the SNF Jan 11, 2021
Individual Adp of the SNF Jan 1, 2023
Etn Family Holdings LLC Organization, Suffern, NY LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jul 15, 2020 13.5%
Adp of the SNF Jan 11, 2021
Lacon Propco One LLC Organization, Pomona, NY LLC Adp of the SNF Jan 11, 2021
Bezalel Stern Individual 5% Or Greater Direct Ownership Interest Jul 15, 2020 13.5%
Adp of the SNF Jan 11, 2021
Individual Adp of the SNF Jan 1, 2023
T Newhouse Family Trust Organization, Suffern, NY 5% Or Greater Indirect Ownership Interest Jul 15, 2020 6.68%
Adp of the SNF Jan 11, 2021
Organization, Cedarhurst, NY Consulting firm Adp of the SNF May 25, 2025
Stanley Mathew Individual Operational/Managerial Control Apr 1, 2025
Managing Control - Governing Body Apr 1, 2025
Adp of the SNF Apr 1, 2025
Eric Newhouse Individual Managing Control - Governing Body Jul 15, 2020
Trustee of the SNF Jul 15, 2020
Indirect Ownership Interest Jul 15, 2020 0.13%
Andrea Plew Individual Operational/Managerial Control Mar 10, 2020
Adp of the SNF Mar 10, 2020
Stern Therapy Consultants LLC Organization, Pomona, NY LLC Operational/Managerial Control Jul 15, 2020
Adp of the SNF May 25, 2025
Organization, Dunlap, IL Consulting firm Adp of the SNF May 25, 2025
Temi Newhouse Individual Trustee of the SNF Jul 15, 2020
Individual Direct Ownership Interest Jul 15, 2020 1.33%
Indirect Ownership Interest Jul 15, 2020 1.33%
Roxanne Dorsey Individual Operational/Managerial Control Jan 11, 2023
Adp of the SNF Jan 11, 2023
E Newhouse Family Trust Organization, Suffern, NY 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.

Facilities with the same owner 22

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

View all 22

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "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

Sources for this page

Verify at the official NPI Registry.