Alden-Northmoor Rehabilitation and Health Care Center, Inc.
Organization Active NPI Skilled Nursing Facility · Chicago, IL
NPI 1821085291 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1821085291
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 0041277 (IL)
- Legal business name
- ALDEN-NORTHMOOR REHABILITATION AND HEALTH CARE CENTER, INC.
- Practice address
- 5831 N Northwest Hwy
Chicago, IL 60631-2642 - Phone
- (773) 775-8080
- Fax
- (773) 775-9672
- NPI assigned
- Sep 30, 2005
- Organization subpart
- No
Authorized official
- Name
- Floyd A Schlossberg
- Title
- President
- Phone
- (773) 286-6622
Corporate family (same tax ID) 1
Facilities with the same owner 28
Affiliated clinicians 2
-
Godwin H D'Souza, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Alden Estates of Northmoor
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jul 8, 1996
- Medicare certification status
- Active
- Certified beds
- 198 · 181.2 residents per day on average
- Chain
- The Alden Network
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Skilled nursing facility certification: CCN 145888
- Legal name
- ALDEN-NORTHMOOR REHABILITATION AND HEALTH CARE CENTER, INC.
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 8, 1996
- Last certification
- Nov 1, 2024
- Beds
- 198
- Ownership / control type
- Corporation
- Multi-facility organization
- Alden Management Services
- Organization structure
- Corporation · Proprietary
- Incorporated
- May 15, 1992 in IL
- Enrollment address
- 5831 N Northwest Hwy
Chicago, IL 60631-2642 - Nursing home name
- ALDEN ESTATES OF NORTHMOOR
- Affiliated entity
- THE ALDEN NETWORK
All disclosed owners & managing parties 18
| Name | Role | Since | Share |
|---|---|---|---|
| Katie N Novak |
W-2 Managing Employee |
May 18, 2015 | 100% |
| Arin G Elisco |
5% Or Greater Indirect Ownership Interest | Jul 1, 2013 | 6.26% |
| Garrett E Magnusson |
5% Or Greater Indirect Ownership Interest | Jul 1, 2013 | 6.26% |
| Joan P Carl |
Corporate Officer | May 10, 2010 | |
| Corporate Director |
May 10, 2010 | ||
| Alden Management Services, Inc. |
Operational/Managerial Control | Oct 9, 1996 | 100% |
| Randi Schullo Grantor TR Dated 11/02/2004 |
5% Or Greater Indirect Ownership Interest | Feb 28, 2018 | 20.77% |
| Joseph Schullo |
5% Or Greater Indirect Ownership Interest | Jul 1, 2013 | 6.26% |
| Robert J Molitor |
Operational/Managerial Control |
Jun 16, 2008 | |
| Lauren Magnusson Grantor TR Dated 11/02/2004 |
5% Or Greater Indirect Ownership Interest | Feb 28, 2018 | 20.77% |
| The Alden Group, LTD. |
5% Or Greater Direct Ownership Interest | Oct 9, 1996 | 100% |
| Paige a Magnusson |
5% Or Greater Indirect Ownership Interest | Jul 1, 2013 | 6.26% |
| Nicole Schullo |
5% Or Greater Indirect Ownership Interest | Jul 1, 2013 | 6.26% |
| Margo Marasa |
Operational/Managerial Control |
Sep 12, 2011 | |
| Randi Schullo |
Corporate Officer | Feb 16, 2010 | |
| Charles L Elisco |
5% Or Greater Indirect Ownership Interest | Jul 1, 2013 | 6.26% |
| Midcap Funding IV Trust |
5% Or Greater Security Interest | Jul 1, 2010 | 40% |
| Floyd a Schlossberg |
Corporate Officer | May 10, 2010 | |
| Corporate Director |
May 10, 2010 | ||
| Audra Elisco Grantor TR Dated 11/02/2004 |
5% Or Greater Indirect Ownership Interest | Mar 1, 2018 | 20.77% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100615000181 | IL | Part a Provider - Skilled Nursing Facility | 9335279504 | Practice locations: Chicago, IL |
National Provider Directory
- Tax ID family
- Alden Northmoor Rehab HC Ctr
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0041277 | IL | Yes |
Addresses
Primary practice location
5831 N Northwest Hwy
Chicago, IL 60631-2642
Mailing address
4200 W Peterson Ave
Suite 140
Chicago, IL 60646-6074
Phone (773) 286-6622
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1115 | Other | IL | BLUE CROSS |
Other providers in Chicago, IL
- Alden Town Manor
- Alden Village North, Inc.
- Alden Village North, Inc.
- Alden-Lakeland Rehabilitation and Health Care Center, Inc.
- Alden-Lincoln Park Rehabilitation and Health Care Center, Inc.
- Alden-Princeton Rehabilitation and Health Care Center, Inc.
- Alden-Wentworth Rehabilitation and Health Care Center, Inc.
- Alison Rose Alden
- Carrie A Alden
- Tord Alden
All providers in Chicago, 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 Aug 22, 2020. 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.