NPIMap

Organization Active NPI

Lombard Skilled Nursing Facility LLC

  • Skilled Nursing Facility
  • Lombard, IL
National Provider Identifier
1619550993
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LOMBARD SKILLED NURSING FACILITY LLC
Practice address
2100 S Finley Rd
Lombard, IL 60148-4830
Phone
(630) 495-4000
Fax
(630) 495-2809
NPI assigned
May 4, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Authorized official

Name
Mordechay Ninio
Title
Cfo
Phone
(847) 676-5315

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

2100 S Finley Rd
Lombard, IL 60148-4830

Mailing address

3450 Oakton St
Skokie, IL 60076-2951
Phone (847) 679-9797

Other names 1

  • Bella Terra Lombard Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210624000175 IL Part A Provider - Skilled Nursing Facility 8820499122 Practice locations: Lombard, IL

Skilled nursing facility certification: CCN 145511

Legal name
LOMBARD SKILLED NURSING FACILITY LLC
Doing business as
BELLA TERRA LOMBARD
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 1, 1985
Last certification
Jun 26, 2024
Beds
224
Ownership / control type
Corporation
Organization structure
LLCProprietary
Enrollment address
2100 S Finley Rd
Lombard, IL 60148-4830
Nursing home name
BELLA TERRA LOMBARD
Affiliated entity
LEGACY HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Bella Terra LombardCCN 145511
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Oct 1, 1985
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
224145.6 residents per day on average
Chain
Legacy Healthcare89 facilities in the chain

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
14D0857744Bella Terra Lombard2100 S Finley Rd, Lombard, IL 60148Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

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.

NameRoleSinceShare
Margaux Morris Individual W-2 Managing EmployeeAdministrator Jun 1, 2021
Mordechay Ninio Individual 5% Or Greater Direct Ownership Interest Jun 1, 2021 58.5%
Tbdmd Il, LLC Organization, Skokie, IL LLC, Management services company, For-profit Operational/Managerial Control Jun 1, 2021
Daniel Garden Individual 5% Or Greater Direct Ownership Interest Jun 1, 2021 7.5%
Other Jun 1, 2021
GPN Family Trust U/a/D 4/28/08 Organization, Skokie, IL 5% Or Greater Direct Ownership Interest Jun 1, 2021 17%
Doros Generation Trust U/a/D 1/3/12 Organization, Skokie, IL 5% Or Greater Direct Ownership Interest Jun 1, 2021 17%

Facilities with the same owner 84

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

View all 84

Practitioners & affiliated clinicians

Affiliated clinicians 6

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": "1620086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624233600000",
    "number": "1619550993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 OAKTON ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762951",
            "telephone_number": "847-679-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 S FINLEY RD",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484830",
            "telephone_number": "630-495-4000",
            "fax_number": "630-495-2809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOMBARD SKILLED NURSING FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-04",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A",
        "authorized_official_last_name": "NINIO",
        "authorized_official_first_name": "MORDECHAY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "847-676-5315"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bella Terra Lombard",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bella Terra Lombard",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lombard, IL

Sources for this page

Verify at the official NPI Registry.