NPIMap

Organization Active NPI

Kindred Chicago Northlake, LLC

Doing business as Kindred Hospital - Chicago (North Campus)

  • Long Term Care Hospital
  • Chicago, IL
National Provider Identifier
1821604125
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
Legal business name
KINDRED CHICAGO NORTHLAKE, LLC
Doing business as
Kindred Hospital - Chicago (North Campus)
Practice address
2544 W Montrose Ave
Chicago, IL 60618-1537
Phone
(773) 267-2622
Fax
(773) 267-2685
NPI assigned
Sep 22, 2020
Last updated
Mar 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Authorized official

Name
Kathy Teague
Title
Vice President, Corporate Secretary
Phone
(629) 253-5121

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X
Long Term Care Hospital 282E00000X Primary

Addresses

Primary practice location

2544 W Montrose Ave
Chicago, IL 60618-1537

Mailing address

2544 W Montrose Ave
Chicago, IL 60618-1537
Phone (773) 267-2622

Other identifiers 1

IdentifierTypeStateIssuer
0006221OtherILSTATE LICENSE

Other names 1

  • Kindred Hospital - Chicago (North Campus) Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201228000164 IL Part A Provider - Hospital 8527470103 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chicago, IL; Northlake, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821604125. Details of each certification follow.

Hospital certification: CCN 142008

Legal name
KINDRED CHICAGO NORTHLAKE, LLC
Doing business as
KINDRED HOSPITAL - CHICAGO
Certification status
Active
Provider type (POS)
Hospital – Long-term
Participating since
Feb 1, 1992
Last certification
Aug 31, 2023
Beds
258
Ownership / control type
Private (for profit)
Most recent change of ownership
Dec 16, 2020 (5 total)
Organization structure
LLCProprietary
Enrollment address
365 E North Ave
Northlake, IL 60164-2628
Main/Primary Hospital Location
Hospital subgroups
Long-term

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Long-term care hospital

Medicare Care Compare
Listed as
Kindred Hospital - ChicagoCCN 142008 · All quality measures
Ownership
For profit
Certified
Feb 1, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Beds
258

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0713842Kindred Chicago Northlake, L L C2544 W Montrose Avenue, Chicago, IL 60618AccreditationApr 27, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Kindred Healthcare Operating LLC Organization, Louisville, KY LLC, For-profit 5% Or Greater Direct Ownership Interest Dec 16, 2020 100%
Kentucky Hospital Intermediate LLC Organization, Louisville, KY LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 16, 2020 100%
Kindred Healthcare LLC Organization, Louisville, KY LLC, For-profit 5% Or Greater Indirect Ownership Interest Dec 16, 2020 100%
Scott Graeser Individual Corporate OfficerVice President, Treasurer Aug 19, 2022
Dana M Rock Individual Corporate OfficerAssistant Administrator Dec 9, 2024
Johnetta M Traylor Individual Corporate OfficerAdministrator Dec 9, 2024
Darla Beranek Individual Corporate OfficerAssistant Corporate Secretary Jan 30, 2026
Kentucky Hospital Holdings LLC Organization, Louisville, KY LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 16, 2020 100%
Nancie Trueman Individual Operational/Managerial ControlChief Executive Officer Dec 1, 2025
Deanna Schiavone Individual Corporate OfficerChief Financial Officer Aug 22, 2022
Knight Health Holdings LLC Organization, Louisville, KY LLC 5% Or Greater Indirect Ownership Interest Dec 23, 2021 100%
Michael Joseph Bean Individual Corporate OfficerVP, Tax Dec 16, 2020
Knight Health LLC Organization, Louisville, KY LLC 5% Or Greater Indirect Ownership Interest Dec 23, 2021 100%
Kentucky Hospital Holdings JV LP Organization, Louisville, KY Holding company 5% Or Greater Indirect Ownership Interest Dec 16, 2020 100%
Linn Billingsley Individual Corporate OfficerPresident Jan 30, 2026

Practitioners & affiliated clinicians

Affiliated clinicians 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710115200000",
    "number": "1821604125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2544 W MONTROSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606181537",
            "telephone_number": "773-267-2622",
            "fax_number": "773-267-2685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2544 W MONTROSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606181537",
            "telephone_number": "773-267-2622",
            "fax_number": "773-267-2685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINDRED CHICAGO NORTHLAKE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-22",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A",
        "authorized_official_last_name": "TEAGUE",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "VICE PRESIDENT, CORPORATE SECRETARY",
        "authorized_official_telephone_number": "629-253-5121"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "0006221",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kindred Hospital - Chicago (North Campus)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kindred Hospital - Chicago (North Campus)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.