NPIMap

Organization Active NPI

Streamwood Skilled Nursing Facility LLC

Doing business as Bella Terra Streamwood

  • Skilled Nursing Facility
  • Streamwood, IL
National Provider Identifier
1649824079
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
STREAMWOOD SKILLED NURSING FACILITY LLC
Doing business as
Bella Terra Streamwood
Practice address
815 E Irving Park Rd
Streamwood, IL 60107-3073
Phone
(630) 837-5300
Fax
(630) 213-9076
NPI assigned
Jul 24, 2019
Last updated
Sep 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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

Authorized official

Name
Menachem Shabat
Title
Member/Coo
Phone
(847) 679-9797

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

815 E Irving Park Rd
Streamwood, IL 60107-3073

Mailing address

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

Other names 1

  • Bella Terra Streamwood Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191001000454 IL Part A Provider - Skilled Nursing Facility 9234469446 Practice locations: Streamwood, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649824079. Details of each certification follow.

Skilled nursing facility certification: CCN 145701

Legal name
STREAMWOOD SKILLED NURSING FACILITY, LLC
Doing business as
BELLA TERRA STREAMWOOD
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 28, 1991
Last certification
Mar 20, 2025
Beds
214
Ownership / control type
Corporation
Multi-facility organization
Legacy Healthcare
Most recent change of ownership
Sep 1, 2019
Organization structure
LLCProprietary
Enrollment address
815 E Irving Park Rd
Streamwood, IL 60107-3073
Nursing home name
BELLA TERRA STREAMWOOD
Affiliated entity
LEGACY HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Bella Terra StreamwoodCCN 145701 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Aug 28, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
214128.8 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
14D0857818Bella Terra Streamwood815 E Irving Park Road, Streamwood, IL 60107Certificate of waiverAug 31, 2026
14D2172642Bella Terra Streamwood815 E Irving Park Rd, Streamwood, IL 60107Certificate of waiverSep 25, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Individual Indirect Ownership Interest Sep 1, 2019 4.9%
Bokf,NA Organization, Tulsa, OK Financial institution 5% Or Greater Security Interest Mar 4, 2024 100%
Operational/Managerial Control Mar 4, 2024
Rajiv K Sood Individual Operational/Managerial Control Sep 1, 2019
Adp of the SNF Sep 1, 2019
Menachem Shabat Individual Operational/Managerial Control Sep 1, 2019
Managing Control - Governing BodyManager of the Manager Sep 1, 2019
Adp of the SNF Sep 1, 2019
Roth & Co, LLP Organization, Brooklyn, NY LLC Adp of the SNF Jan 1, 2024
Individual Adp of the SNF Sep 1, 2019
Individual Indirect Ownership Interest Sep 1, 2019 2.6%
Streamwood Property Holdings, LLC Organization, Skokie, IL LLC 5% Or Greater Security Interest Sep 1, 2019 100%
Adp of the SNF Sep 1, 2019
GPN Family Trust U/a/D 4/28/08 Organization, Skokie, IL 5% Or Greater Direct Ownership Interest Dec 27, 2019 42.5%
Adp of the SNF Sep 1, 2019
Legacy Healthcare Financial Services LLC Organization, Skokie, IL LLC, For-profit Operational/Managerial Control Sep 1, 2019
Adp of the SNF Nov 12, 2025
Oakway Operations LLC Organization, Skokie, IL LLC 5% Or Greater Direct Ownership Interest Dec 27, 2019 15%
Individual Indirect Ownership Interest Sep 1, 2019 4.9%
Doros Generation Trust U/a/D 1/3/12 Organization, Skokie, IL 5% Or Greater Direct Ownership Interest Dec 27, 2019 42.5%
Adp of the SNF Sep 1, 2019
Individual Indirect Ownership Interest Sep 1, 2019 2.6%
Debbie Randon Individual Operational/Managerial Control Sep 12, 2022
Adp of the SNF Sep 12, 2022

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 90

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

View all 90

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1563926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568160000000",
    "number": "1649824079",
    "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",
            "fax_number": "847-679-5348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 E IRVING PARK RD",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601073073",
            "telephone_number": "630-837-5300",
            "fax_number": "630-213-9076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STREAMWOOD SKILLED NURSING FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-24",
        "last_updated": "2019-09-11",
        "status": "A",
        "authorized_official_last_name": "SHABAT",
        "authorized_official_first_name": "MENACHEM",
        "authorized_official_title_or_position": "MEMBER/COO",
        "authorized_official_telephone_number": "847-679-9797"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bella Terra Streamwood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Streamwood, IL

Sources for this page

Verify at the official NPI Registry.