NPIMap

Organization Active NPI

Pearl of Elgin, LLC

  • Skilled Nursing Facility
  • Elgin, IL
National Provider Identifier
1669246500
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PEARL OF ELGIN, LLC
Practice address
2355 Royal Blvd
Elgin, IL 60123-4716
Phone
(847) 888-9585
NPI assigned
Nov 10, 2023
Last updated
Nov 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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

Authorized official

Name
Eitan Zeffren
Title
Authorized Official
Phone
(847) 888-9585

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

2355 Royal Blvd
Elgin, IL 60123-4716

Mailing address

6865 N Lincoln Ave
Lincolnwood, IL 60712-4611

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240624001263 IL Part A Provider - Skilled Nursing Facility 1557804176 Practice locations: Elgin, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669246500. Details of each certification follow.

Skilled nursing facility certification: CCN 145821

Legal name
PEARL OF ELGIN, LLC
Doing business as
THE PEARL OF ELGIN
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 7, 1994
Last certification
Aug 22, 2024
Beds
139
Ownership / control type
Limited Liability Corporation
Most recent change of ownership
Dec 1, 2023
Organization structure
LLCProprietary
Enrollment address
2355 Royal Blvd
Elgin, IL 60123-4716
Nursing home name
PEARL OF ELGIN, THE
Affiliated entity
PEARL HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Pearl of Elgin, theCCN 145821 · All quality measures
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 - Limited Liability company
Certified
Dec 7, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
139125.3 residents per day on average
Chain
Pearl Healthcare15 facilities in the chain
Penalties (3 years)
2Fines totaling $19,250

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
14D2176802Pearl of Elgin, the2355 Royal Blvd, Elgin, IL 60123Certificate of waiverDec 25, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Ez Holdco LLC Organization, Lincolnwood, IL LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 1, 2023 60%
Meyer Magence Individual OtherTrustee of Reg 2018 Irrevocable Dec 1, 2023 20%
Hooli Operations LLC Organization, Lincolnwood, IL LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 1, 2023 20%
Reynaldo Querubin Individual W-2 Managing EmployeeAd; Dec 1, 2023
CCG Barbados, LLC Organization, Skokie, IL LLC, Holding company, Owned by another organization or individual 5% Or Greater Security Interest Dec 1, 2023
Eliyahu Grinblatt Individual 5% Or Greater Indirect Ownership Interest Dec 1, 2023 20%
Hina Nawab Individual Contracted Managing Employee Dec 1, 2023
Eitan Zeffren Individual 5% Or Greater Indirect Ownership Interest Dec 1, 2023 60%
Corporate OfficerManager of the Provider LLC Dec 1, 2023
2355 Royal Blvd LLC Organization, Tampa, FL LLC, Owned by another organization or individual 5% Or Greater Security Interest Dec 1, 2023
Reg 2018 Irrevocable Trust U/a/D 1/1/18 Organization, Skokie, IL 5% Or Greater Indirect Ownership Interest Dec 1, 2023 20%
PHC Elgin Holdings LLC Organization, Lincolnwood, IL LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 1, 2023 99.99%

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 13

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

View all 13

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": "1699574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699574400000",
    "number": "1669246500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6865 N LINCOLN AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607124611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 ROYAL BLVD",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601234716",
            "telephone_number": "847-888-9585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARL OF ELGIN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-10",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A",
        "authorized_official_last_name": "ZEFFREN",
        "authorized_official_first_name": "EITAN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "847-888-9585"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

Verify at the official NPI Registry.