Washington and Jane Smith Community Beverly

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0015032 Issued in IL

Legal business name

WASHINGTON AND JANE SMITH COMMUNITY BEVERLY

Practice address

11308 S Oakley Ave
Chicago, IL 60643-4112

Phone

(773) 474-7300

Fax

(773) 474-7342

NPI assigned

Mar 7, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Raymond Marneris

Title

Cfo

Phone

(773) 474-7350

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Smith Village Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Skilled nursing facility certification: CCN 145904

Legal name

WASHINGTON AND JANE SMITH COMMUNITY BEVERLY

Doing business as

SMITH VILLAGE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Sep 16, 1996

Last certification

Sep 19, 2024

Beds

93

Ownership / control type

Other Nonprofit

Multi-facility organization

Smith Senior Living

Organization structure

CorporationNon-profit

Incorporated

May 24, 1926 in IL

Enrollment address

11308 S Oakley Ave
Chicago, IL 60643-4112

Nursing home name

SMITH VILLAGE

Listed as

Smith VillageCCN 145904

Overall star rating

3 of 5

Health inspections

2 of 5

Staffing

5 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Other

Certified

Sep 16, 1996

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

7865.9 residents per day on average

Abuse citation

Cited for abuse (Care Compare abuse icon)

Penalties (3 years)

2Fines totaling $16,350

Processed by Care Compare on Aug 1, 2026.

Locations

All disclosed owners & managing parties 6

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

Owners & managing parties with NPI records 1

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

• Smain Sadok, M.D

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1891916383

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Matthew Scott Hanlon, D.O.

  • Family Medicine Physician
  • Oak Lawn, IL
  • NPI 1104937622

  Nursing home

  Care Compare affiliation
• Smain Sadok, M.D

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1891916383

  Nursing home

  Care Compare affiliation
• Ashraf Anani, M.D.

  • Internal Medicine Physician
  • Round Rock, TX
  • NPI 1629041710

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380672000000",
    "number": "1609843754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 W 113TH PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606434117",
            "telephone_number": "773-474-7300",
            "fax_number": "773-474-7342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11308 S OAKLEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606434112",
            "telephone_number": "773-474-7300",
            "fax_number": "773-474-7342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON AND JANE SMITH COMMUNITY BEVERLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-07",
        "last_updated": "2013-10-02",
        "status": "A",
        "authorized_official_last_name": "MARNERIS",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "773-474-7350",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0015032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000015032",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smith Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katherine Washagan, PA-C
• Rachel Marie Washart
• Jason J. Washburn, PH.D., ABPP
• Kathryn Jane Washburn, M.S. SLP
• Krista Decoursey Washburn, PA-C
• Katie Odette Washington Cole, MD-PHD
• Washington Heights Care Center, LLC
• Washington International Solutions LLC
• Ann Wood Washington, PH.D.
• Ashley Washington

• Skilled Nursing Facility in Chicago, IL
• Providers in Chicago, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; 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.

Verify at the official NPI Registry.