NPIMap

Organization Active NPI

Sisters of Charity of Our Lady Mother of the Church

  • Skilled Nursing Facility
  • Janesville, WI
National Provider Identifier
1598766784
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0624 Issued in WI
Legal business name
SISTERS OF CHARITY OF OUR LADY MOTHER OF THE CHURCH
Practice address
109 S Atwood Ave
Janesville, WI 53545-4098
Phone
(608) 752-6709
NPI assigned
Aug 10, 2005
Last updated
Jul 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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

Authorized official

Name
Ms. Julie Marks
Title
Cfo
Phone
(920) 261-0400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0624 WI Primary

Addresses

Primary practice location

109 S Atwood Ave
Janesville, WI 53545-4098

Mailing address

1045 Hill St
Watertown, WI 53098-3015
Phone (920) 206-4983

Other identifiers 1

IdentifierTypeStateIssuer
20167600MedicaidWI

Other names 1

  • ST. ELIZABETH NURSING HOME Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091112000450 WI Part A Provider - Skilled Nursing Facility 7911045844 Practice locations: Janesville, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1598766784. Details of each certification follow.

Skilled nursing facility certification: CCN 525639

Legal name
SISTERS OF CHARITY OF OUR LADY MOTHER OF THE CHURCH
Doing business as
ST ELIZABETH NURSING HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 1, 1998
Last certification
Feb 13, 2025
Beds
43
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Illuminus
Organization structure
CorporationNon-profit
Incorporated
Aug 10, 1974 in WI
Enrollment address
109 S Atwood Ave
Janesville, WI 53545-4098
Nursing home name
ST ELIZABETH NURSING HOME
Affiliated entity
ILLUMINUS

Care Compare: Nursing home

Medicare Care Compare
Listed as
St Elizabeth Nursing HomeCCN 525639 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Feb 1, 1998
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4340.3 residents per day on average
Chain
Illuminus5 facilities in the chain
Penalties (3 years)
2Fines totaling $31,171

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
52D0856717Saint Elizabeth Nursing Home109 S Atwood Ave, Janesville, WI 53545Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Matthew R Mauthe Individual Corporate OfficerCeo Apr 30, 2018
Operational/Managerial Control Apr 30, 2018
Adp of the SNF Apr 30, 2018
Deanna Wilson Individual Operational/Managerial Control Oct 28, 2024
Adp of the SNF Apr 22, 2025
Todd Fischer Individual Corporate DirectorBoard Chair Apr 30, 2018
Illuminus Inc Organization, Watertown, WI Corporation, Management services company, Non-profit Operational/Managerial Control Apr 30, 2018
Adp of the SNF Oct 17, 2025
Scott Dettman Individual Corporate DirectorSecretary/Treasurer Sep 1, 2020
Sarfraz Sidhu Individual Operational/Managerial Control Apr 6, 2021
Adp of the SNF Apr 6, 2021
Kevin Kohlhoff Individual Corporate DirectorDirector Sep 1, 2023
Robert Meidenbauer Individual Corporate DirectorVice Chair Sep 1, 2019
Katie Van Der Linden Individual Corporate DirectorDirector May 1, 2021
Dennis Konkol Individual Corporate DirectorDirector Oct 1, 2024
Steven Heroux Individual Corporate DirectorDirector Aug 1, 2024
Lynne Wagner Individual Corporate DirectorDirector Oct 1, 2024
Julie Marks Individual Corporate OfficerCfo Jun 9, 2025
Adp of the SNF Jun 9, 2025

Owners & managing parties with NPI records 1

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

Facilities with the same owner 10

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

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": "1123632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783641600000",
    "number": "1598766784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 HILL ST",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983015",
            "telephone_number": "920-206-4983",
            "fax_number": "920-261-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 S ATWOOD AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535454098",
            "telephone_number": "608-752-6709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SISTERS OF CHARITY OF OUR LADY MOTHER OF THE CHURCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-10",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A",
        "authorized_official_last_name": "MARKS",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "920-261-0400",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "0624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20167600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST. ELIZABETH NURSING HOME",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "ST. ELIZABETH NURSING HOME",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Janesville, WI

Sources for this page

Verify at the official NPI Registry.