NPIMap

Organization Active NPI

Integrated Palliative and Hospice LLC

Doing business as Integrated Palliative and Hospice

  • Community Based Hospice Care Agency
  • Libertyville, IL
National Provider Identifier
1639417959
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
2003010 Issued in IL
Legal business name
INTEGRATED PALLIATIVE AND HOSPICE LLC
Doing business as
Integrated Palliative and Hospice
Practice address
151 W Golf Rd
Libertyville, IL 60048-3213
Phone
(847) 682-4304
Fax
(866) 341-2867
NPI assigned
Jan 21, 2013
Last updated
Oct 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Authorized official

Name
Mr. Rowena J. OlivaNPI 1528124864
Title
Administrator
Phone
(847) 682-4304

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 2003010 IL Primary

Addresses

Primary practice location

151 W Golf Rd
Libertyville, IL 60048-3213

Mailing address

151 W Golf Rd
Libertyville, IL 60048-3213
Phone (847) 549-0588

Other names 1

  • Integrated Palliative and Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130410000323 IL Part A Provider - Hospice 2860638244 Practice locations: Libertyville, IL
O20170619000952 IL Part B Supplier - Clinic/Group Practice 2860638244 Receives reassigned benefits from 6 practitioners
Practice locations: Libertyville, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639417959. Details of each certification follow.

Hospice certification: CCN 141653

Legal name
INTEGRATED PALLIATIVE AND HOSPICE LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 21, 2013
Last certification
Jul 28, 2022
Ownership / control type
Other
Organization structure
LLCProprietary
Incorporated
Jul 13, 2011 in IL
Enrollment address
151 W Golf Rd
Libertyville, IL 60048-3213

Care Compare: Hospice

Medicare Care Compare
Listed as
Integrated Palliative and Hospice LLCCCN 141653 · All quality measures
Ownership
For-Profit
Certified
Aug 21, 2013
Medicare certification status
ActiveFrom the Provider of Services file

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
14D2053478Integrated Palliative and Hospice151 W Golf Rd, Libertyville, IL 60048Certificate of waiverJan 31, 2027

National Provider Directory

National Provider Directory

Locations

900 Technology Way
Ste 280
Libertyville, IL 60048
Phone (847) 549-0588

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Allan Oliva Individual 5% Or Greater Direct Ownership Interest Jul 13, 2011 50%
Limited Partnership Interest Jul 13, 2011 50%
Corporate Officer Aug 31, 2012 50%
W-2 Managing Employee Jul 13, 2011 50%
Rowena J Oliva Individual 5% Or Greater Direct Ownership Interest Jul 13, 2011 50%
Limited Partnership Interest Jul 13, 2011 50%
Corporate Director Aug 31, 2012 100%
W-2 Managing Employee Jul 13, 2011
David J Slivnick Individual W-2 Managing EmployeeMD; Aug 15, 2025 5%

Owners & managing parties with NPI records 2

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

  • Rowena Oliva, NP
    • Nurse Practitioner
    • Libertyville, IL
    • NPI 1528124864

    5% Or Greater Direct Ownership Interest, Corporate Director, Limited Partnership Interest, W-2 Managing Employee

    CMS ownership
  • David J Slivnick, MD
    • Hematology & Oncology Physician
    • Libertyville, IL
    • NPI 1225082761

    W-2 Managing Employee

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 5

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": "1358726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664841600000",
    "number": "1639417959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 W GOLF RD",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483213",
            "telephone_number": "847-549-0588",
            "fax_number": "847-549-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 W GOLF RD",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483213",
            "telephone_number": "847-682-4304",
            "fax_number": "866-341-2867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED PALLIATIVE AND HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-21",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A",
        "authorized_official_last_name": "OLIVA",
        "authorized_official_first_name": "ROWENA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "847-682-4304",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "IL",
            "license": "2003010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integrated Palliative and Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.