NPIMap

Organization Active NPI

Residential Hospice of Southern Illinois, LLC

  • Community Based Hospice Care Agency
  • Glen Carbon, IL
National Provider Identifier
1720405301
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
RESIDENTIAL HOSPICE OF SOUTHERN ILLINOIS, LLC
Practice address
4215 S State Route 159
Glen Carbon, IL 62034-3267
Phone
(800) 358-8227
Fax
(888) 229-8388
NPI assigned
Mar 21, 2014
Last updated
Jan 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Authorized official

Name
Karen L Sloaf
Title
Manager of Regulatory Affairs
Phone
(800) 358-8227

Specialties & licenses 1

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

Addresses

Primary practice location

4215 S State Route 159
Glen Carbon, IL 62034-3267

Mailing address

5440 Corporate Dr Ste 400
Troy, MI 48098-2645
Phone (866) 902-4000

Other practice location 1

104 Airway Dr Ste 1
Marion, IL 62959-5841
Phone (800) 358-8227

Other names 1

  • Celtic Hospice & Palliative Care Services of S. IL, LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140605002188 IL Part A Provider - Hospice 3678797966 Practice locations: Marion, IL; Glen Carbon, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720405301. Details of each certification follow.

Hospice certification: CCN 141576

Legal name
RESIDENTIAL HOSPICE OF SOUTHERN ILLINOIS, LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Nov 30, 1994
Last certification
Dec 1, 2016
Ownership / control type
Proprietary - Other
Organization structure
LLCProprietary
Incorporated
Feb 7, 2014 in PA
Enrollment address
4215 S State Route 159
Glen Carbon, IL 62034-3267

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Residential Hospice of Southern IllinoisCCN 141576 · All quality measures
Ownership
For-Profit
Certified
Nov 30, 1994
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Celtic Hospice Palliative Care Services of S Il LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Karen Sloaf Individual Operational/Managerial ControlDirector of Regulatory Affairs Oct 9, 2025
Leeann Lang Individual Corporate OfficerSenior VP of Administration Oct 9, 2025
Wendy R Bongero Individual Operational/Managerial ControlAlternate Administrator Jun 13, 2017
Graham Healthcare Group Inc Organization, Troy, MI Corporation, For-profit 5% Or Greater Indirect Ownership Interest Jun 15, 2016 100%
Deedrea Grein Individual Corporate OfficerCeo Dec 1, 2025
Graham Holdings Company Organization, Arlington, VA Holding company 5% Or Greater Indirect Ownership Interest Jun 15, 2016 100%
Andrew John Hossler Individual Contracted Managing EmployeeMD; Dec 17, 2024
Jason Pierce Individual Corporate OfficerCfo Oct 9, 2025
Celtic Healthcare Inc & Qualified Subsidiaries Organization, Troy, MI Corporation, For-profit 5% Or Greater Direct Ownership Interest Apr 1, 2014 100%
Traci Ann Saunders Individual W-2 Managing EmployeeAd; May 9, 2024

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 29

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

View all 29

Practitioners & affiliated clinicians

Practitioners 2

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 4

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": "1395360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768348800000",
    "number": "1720405301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 CORPORATE DR STE 400",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480982645",
            "telephone_number": "866-902-4000",
            "fax_number": "866-903-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 S STATE ROUTE 159",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620343267",
            "telephone_number": "800-358-8227",
            "fax_number": "888-229-8388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Airway Dr Ste 1",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "IL",
            "postal_code": "629595841",
            "country_code": "US",
            "telephone_number": "800-358-8227",
            "fax_number": "888-229-8388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RESIDENTIAL HOSPICE OF SOUTHERN ILLINOIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-21",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A",
        "authorized_official_last_name": "SLOAF",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER OF REGULATORY AFFAIRS",
        "authorized_official_telephone_number": "800-358-8227"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Celtic Hospice & Palliative Care Services of S. IL, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Glen Carbon, IL

Sources for this page

Verify at the official NPI Registry.