Active NPI
Hitz Memorial Home
- Skilled Nursing Facility
- Alhambra, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 0032979
- Legal business name
- HITZ MEMORIAL HOME
- Practice address
- 201 Belle
Alhambra, IL 62001 - Phone
- (618) 488-2355
- Fax
- (618) 488-2361
- NPI assigned
- Jul 17, 2006
- Last updated
- Nov 2, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Susan Tudor
- Title
- Administrator
- Phone
- (618) 488-2355
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0032979 | IL | Primary |
Addresses
Primary practice location
201 Belle
Alhambra, IL 62001
Mailing address
PO Box 79
Alhambra, IL 62001-0079
Phone (618) 488-2355
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111027000167 | IL | Part A Provider - Skilled Nursing Facility | 9335312966 | Practice locations: Alhambra, IL |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1780602722. Details of each certification follow.
Skilled nursing facility certification: CCN 145921
- Legal name
- HITZ MEMORIAL HOME
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Mar 1, 1997
- Last certification
- Sep 12, 2024
- Beds
- 67 (59 certified)
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Enrollment address
- 201 Bell St
Alhambra, IL 62001-3049 - Nursing home name
- HITZ MEMORIAL HOME
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Hitz Memorial Home
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Mar 1, 1997
- Medicare certification status
- Active
- Certified beds
- 59
- Penalties (3 years)
- 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D0725625 | Hitz Memorial Home | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 14
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| David Scheldt | Corporate Officer | Jan 1, 2024 | |
| Adp of the SNF | Jan 1, 2024 | ||
| Jeremy Wood | Corporate Officer | Oct 25, 2021 | |
| Adp of the SNF | Oct 25, 2021 | ||
| David Hooks | Corporate Officer | Jan 1, 2022 | |
| Adp of the SNF | Jan 1, 2022 | ||
| Terri Hosto | Corporate Officer | Jan 1, 2020 | |
| Adp of the SNF | Jan 1, 2020 | ||
| Makenzie Linn Wilson | Corporate Director | Jul 2, 2021 | 100% |
| Operational/Managerial Control | Jul 2, 2021 | 100% | |
| Adp of the SNF | Sep 4, 2020 | ||
| Dean F Schueler | Corporate Director | Mar 1, 2013 | |
| Operational/Managerial Control | Mar 1, 2013 | ||
| Adp of the SNF | Mar 1, 2013 | ||
| Christine Dauderman | Corporate Officer | Feb 28, 2022 | |
| Adp of the SNF | Feb 28, 2022 | ||
| Margie Ann Schmidt | Corporate Officer | Jan 21, 2019 | |
| Adp of the SNF | Jan 21, 2019 | ||
| Janelle Gelly | Corporate Officer | Jan 1, 2023 | |
| Adp of the SNF | Jan 1, 2023 | ||
| Lisa Uhe | Corporate Officer | Jan 1, 2024 | |
| Adp of the SNF | Jan 1, 2024 | ||
| Randy Strohmeier | Corporate Officer | Jan 1, 2022 | |
| Adp of the SNF | Jan 1, 2022 | ||
| Carol Reckman | Corporate Officer | Jan 1, 2023 | |
| Adp of the SNF | Jan 1, 2023 | ||
| Richard Suhre | Corporate Officer | Jan 21, 2019 | |
| Adp of the SNF | Jan 21, 2019 | ||
| Ashley Ernst | Corporate Officer | Jan 25, 2021 | |
| Adp of the SNF | Jan 25, 2021 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Maryville, IL
- NPI 1417916099
Adp of the SNF, Corporate Director, Operational/Managerial Control
Practitioners & affiliated clinicians
Affiliated clinicians 1
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": "1153094400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1320192000000",
"number": "1780602722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 79",
"city": "ALHAMBRA",
"state": "IL",
"postal_code": "620010079",
"telephone_number": "618-488-2355",
"fax_number": "618-488-2361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 BELLE",
"city": "ALHAMBRA",
"state": "IL",
"postal_code": "62001",
"telephone_number": "618-488-2355",
"fax_number": "618-488-2361"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HITZ MEMORIAL HOME",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-17",
"last_updated": "2011-11-02",
"status": "A",
"authorized_official_last_name": "TUDOR",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "618-488-2355"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "IL",
"license": "0032979",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Alhambra, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; 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.