Prairie Crossing Living & Rehabilitation Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0052126 Issued in IL

Legal business name

PRAIRIE CROSSING LIVING & REHABILITATION CENTER, LLC

Practice address

409 W Comanche Ave
Shabbona, IL 60550-9790

Phone

(815) 824-2194

Fax

(815) 824-2188

NPI assigned

Jan 7, 2013

Last updated

Jul 25, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Moshe Herman

Title

Member

Phone

(847) 982-2300

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730426149. Details of each certification follow.

• CCN 145414 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 145414

Legal name

PRAIRIE CROSSING LIVING & REHABILITATION CENTER LLC

Doing business as

PRAIRIE CROSSING LIVING & REHABILITATION CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Oct 1, 1980

Last certification

Oct 3, 2024

Beds

91

Ownership / control type

Limited Liability Corporation

Most recent change of ownership

Dec 1, 2012

Organization structure

LLCProprietary

Enrollment address

409 W Comanche Ave
Shabbona, IL 60550-9790

Nursing home name

PRAIRIE CROSSING LVG & REHAB

Listed as

Prairie Crossing LVG & RehabCCN 145414 · All quality measures

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

2 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Oct 1, 1980

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

9154.6 residents per day on average

Penalties (3 years)

4Fines totaling $39,635

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Prairie Crossing Living and Rehabilitation Center2 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.

• Prairie Crossing Living and Rehabilitation Center

  • Oxygen Equipment & Supplies (DME)
  • Skokie, IL
  • NPI 1306276597
  NPD tax ID

All disclosed owners & managing parties 16

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

Owners & managing parties with NPI records 1

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

• Erik David Englehart, M.D.

  • Family Medicine Physician
  • Sandwich, IL
  • NPI 1679581367

  Adp of the SNF, Corporate Officer, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 2

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

• Franklin Grove Living & Rehabilitation Center, LLC

  • Skilled Nursing Facility
  • Franklin Grove, IL
  • NPI 1720360183

  Momentum Healthcare LLC

  CMS ownership
• Oregon Living & Rehabilitation Center, LLC

  • Skilled Nursing Facility
  • Oregon, IL
  • NPI 1255613691

  Momentum Healthcare LLC

  CMS ownership

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Erik David Englehart, M.D.

  • Family Medicine Physician
  • Sandwich, IL
  • NPI 1679581367

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721865600000",
    "number": "1730426149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4950 MADISON ST STE 429",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600772570",
            "telephone_number": "847-982-2300",
            "fax_number": "847-982-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W COMANCHE AVE",
            "city": "SHABBONA",
            "state": "IL",
            "postal_code": "605509790",
            "telephone_number": "815-824-2194",
            "fax_number": "815-824-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE CROSSING LIVING & REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-07",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "MOSHE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "847-982-2300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0052126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret T Corcoran, LCSW
• Andrzej Gasiorowski
• Health Progress, Inc. (dba Kish Health Family Care)
• Indian Creek Cusd 425
• Prairie Crossing Assisted Living, LLC
• Shabbona Comm Fire District
• Shabbona Health Care Center
• Shabbona Helath Care Center
• Shabbona Supportive Living (none)
• Shabbona Supportive Living

• Skilled Nursing Facility in Shabbona, IL
• Providers in Shabbona, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.