Sullivan Healthcare & Senior Living LLC
Organization Active NPI Skilled Nursing Facility · Sullivan, IL
NPI 1679396162 · NPPES record last updated Mar 21, 2025
Key facts
- NPI
- 1679396162
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- SULLIVAN HEALTHCARE & SENIOR LIVING LLC
- Practice address
- 11 Hawthorne LN
Sullivan, IL 61951-9490 - Phone
- (217) 728-4327
- NPI assigned
- Nov 4, 2024
- Organization subpart
- No
Authorized official
- Name
- Kevin Chankin
- Title
- Authorized Official
- Phone
- (773) 745-1107
Owners & managing parties with NPI records 1
-
Faisal Bukhari, MD SC
Facilities with the same owner 24
Affiliated clinicians 1
-
Faisal Bukhari, MD SC
Medicare Care Compare: Nursing home
- Listed as
- Sullivan Healthcare & Senior Living
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★☆☆☆☆ 1 of 5
- Quality measures
- ★☆☆☆☆ 1 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- May 1, 1978
- Medicare certification status
- Active
- Certified beds
- 123 · 74.1 residents per day on average
- Chain
- Pointe Management
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
- Penalties (3 years)
- 3 · fines totaling $159,409
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Skilled nursing facility certification: CCN 145370
- Legal name
- SULLIVAN HEALTHCARE & SENIOR LIVING LLC
- Doing business as
- SULLIVAN HEALTHCARE & SENIOR LIVING
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- May 1, 1978
- Last certification
- Sep 13, 2024
- Beds
- 123
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC · Proprietary
- Enrollment address
- 11 Hawthorne LN
Sullivan, IL 61951-9490 - Nursing home name
- SULLIVAN HEALTHCARE & SENIOR LIVING
- Affiliated entity
- POINTE MANAGEMENT
All disclosed owners & managing parties 19
| Name | Role | Since | Share |
|---|---|---|---|
| Afmzl, LLC |
5% Or Greater Indirect Ownership Interest | Dec 1, 2024 | 25% |
| Shimon Webster |
5% Or Greater Indirect Ownership Interest | Dec 1, 2024 | 18.35% |
| Operational/Managerial Control | Dec 1, 2024 | ||
| Adp of the SNF | Dec 1, 2024 | ||
| Aharon Weiss |
5% Or Greater Indirect Ownership Interest | Dec 1, 2024 | 25% |
| Operational/Managerial Control | Dec 1, 2024 | ||
| Adp of the SNF | Dec 1, 2024 | ||
| Yeruchom Levovitz |
5% Or Greater Indirect Ownership Interest | Dec 1, 2024 | 18.35% |
| Operational/Managerial Control | Dec 1, 2024 | ||
| Adp of the SNF | Dec 1, 2024 | ||
| Plante & Moran PLLC |
Adp of the SNF | Dec 1, 2024 | |
| Ecapital Healthcare Corp |
5% Or Greater Security Interest | Dec 1, 2024 | 100% |
| Operational/Managerial Control | Dec 1, 2024 | ||
| Lincoln Healthcare Group, LLC |
Operational/Managerial Control | Dec 1, 2024 | |
| Adp of the SNF | Dec 1, 2024 | ||
| Linicare Holdco LLC |
5% Or Greater Direct Ownership Interest | Dec 1, 2024 | 99.99% |
| Operational/Managerial Control | Dec 1, 2024 | ||
| Adp of the SNF | Dec 1, 2024 | ||
| Avrohom Ribiat |
5% Or Greater Indirect Ownership Interest | Dec 1, 2024 | 25% |
| |
Direct Ownership Interest | Dec 1, 2024 | 0.01% |
| Amanda Spade |
Operational/Managerial Control | Dec 1, 2024 | |
| Adp of the SNF | Dec 1, 2024 | ||
| |
Adp of the SNF | Dec 1, 2024 | |
| Faisal Bukhari |
Operational/Managerial Control | Dec 1, 2024 | |
| Adp of the SNF | Dec 1, 2024 | ||
| Kevin Chankin |
5% Or Greater Indirect Ownership Interest | Dec 1, 2024 | 10% |
| Managing Control - Governing Body |
Dec 1, 2024 | ||
| Janelle Holthaus |
Operational/Managerial Control | Dec 1, 2024 | |
| Adp of the SNF | Dec 1, 2024 | ||
| Stonewall HCG LLC |
5% Or Greater Indirect Ownership Interest | Dec 1, 2024 | 25% |
| |
Adp of the SNF | Dec 1, 2024 | |
| |
Adp of the SNF | Apr 9, 2025 | |
| S & C Holdings Illinois LLC |
5% Or Greater Indirect Ownership Interest | Dec 1, 2024 | 36.7% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250203000514 | IL | Part a Provider - Skilled Nursing Facility | 9032648290 | Practice locations: Sullivan, IL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
11 Hawthorne LN
Sullivan, IL 61951-9490
Mailing address
8153 Lawndale Ave
Skokie, IL 60076-3321
Other providers in Sullivan, IL
- Amanda Sides
- Mary Stutzman
- Sullivan Comm Unit School District 300
- Sullivan Hco, LLC
- Sullivan Hco, LLC
- Sullivan Senior Living LLC
- Nell Sundra
- Mohammad Tabatabaei
- Thomas C. Best, O.D.
- Lisa V Thomas
All providers in Sullivan, IL · Skilled Nursing Facility in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.