NPIMap

Organization Active NPI

Spring Creek SNF LLC

  • Skilled Nursing Facility
  • Joliet, IL
National Provider Identifier
1487115374
Registry record updated Mar 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SPRING CREEK SNF LLC
Practice address
777 Draper Ave
Joliet, IL 60432-1417
Phone
(815) 727-4794
NPI assigned
Mar 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2019

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

Authorized official

Name
Moshe Blonder
Title
Manager
Phone
(815) 727-4794

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

777 Draper Ave
Joliet, IL 60432-1417

Mailing address

6302 N Monticello Ave
Chicago, IL 60659-1210

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190730002800 IL Part A Provider - Skilled Nursing Facility 6406182351 Practice locations: Joliet, IL

Skilled nursing facility certification: CCN 146172

Legal name
SPRING CREEK SNF LLC
Doing business as
SPRING CREEK
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 14, 2014
Last certification
Oct 25, 2024
Beds
168
Ownership / control type
Corporation
Multi-facility organization
SABA Healthcare
Organization structure
LLCProprietary
Enrollment address
777 Draper Ave
Joliet, IL 60432-1417
Nursing home name
SPRING CREEK
Affiliated entity
SABA HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Spring CreekCCN 146172
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Aug 14, 2014
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
168118.1 residents per day on average
Chain
Saba Healthcare11 facilities in the chain
Penalties (3 years)
1Fines totaling $19,135

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
14D2174984Spring Creek S N F777 Draper Ave, Joliet, IL 60432Certificate of waiverNov 12, 2027

National Provider Directory

National Provider Directory

Locations

3531 Howard St
Ste 1006
Skokie, IL 60076

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Wissati Irrevocable Trust Organization, Evanston, IL 5% Or Greater Direct Ownership Interest Mar 3, 2021 33.33%
Aharon Singer Individual 5% Or Greater Direct Ownership Interest May 1, 2019 33.33%
Corporate OfficerManager May 1, 2019
Jayne Maher Individual W-2 Managing EmployeeAdministrator Dec 20, 2021
Moshe Blonder Individual 5% Or Greater Direct Ownership Interest May 1, 2019 33.33%
Corporate OfficerManager, Highest Ranking Officer May 1, 2019

Facilities with the same owner 14

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

View all 14

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": "1553472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553472000000",
    "number": "1487115374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6302 N MONTICELLO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606591210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 DRAPER AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604321417",
            "telephone_number": "815-727-4794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRING CREEK SNF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-25",
        "last_updated": "2019-03-25",
        "status": "A",
        "authorized_official_last_name": "BLONDER",
        "authorized_official_first_name": "MOSHE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "815-727-4794"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.