Active NPI
Willow Branch Hospice, LLC
- Community Based Hospice Care Agency
- Chicago, IL
National Provider Identifier
1831903723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- WILLOW BRANCH HOSPICE, LLC
- Practice address
- 5333 N Sheridan Rd
Chicago, IL 60640-7371 - Phone
- (872) 351-4991
- NPI assigned
- Feb 3, 2025
- 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
- Jon Deluca
- Title
- President
- Phone
- (872) 351-4991
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
5333 N Sheridan Rd
Chicago, IL 60640-7371
Mailing address
5333 N Sheridan Rd
Chicago, IL 60640-7371
Other names 1
- Willow Branch Hospice
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250917003554 | IL | Part A Provider - Hospice | 0042714693 | Practice locations: Chicago, IL |
Hospice certification: CCN 141748
- Legal name
- WILLOW BRANCH HOSPICE, LLC
- Doing business as
- WILLOW BRANCH HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Oct 16, 2025
- Last certification
- Oct 16, 2025
- Ownership / control type
- Proprietary - Other
- Organization structure
- LLC
- Enrollment address
- 5333 N Sheridan Rd
Ste 300
Chicago, IL 60640-7371
Care Compare: Hospice
Medicare Care Compare- Listed as
- Willow Branch Hospice, LLC
- Certified
- Oct 16, 2025
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
5333 N Sheridan Rd
Ste 300
Chicago, IL 60640
Phone (872) 351-4991
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Theodore O'Brien | 5% Or Greater Direct Ownership Interest | Oct 7, 2024 | 12.5% |
| Justin Robins | 5% Or Greater Direct Ownership Interest | Oct 7, 2024 | 12.5% |
| Jerrold Howard Frumm | 5% Or Greater Direct Ownership Interest | Oct 7, 2024 | 12.5% |
| Melissa Weber | W-2 Managing Employee | May 7, 2025 | 50% |
| Stephen James Levy | 5% Or Greater Direct Ownership Interest | Oct 7, 2024 | 10% |
| Corporate Director | Oct 7, 2024 | ||
| Chirag Patel | Contracted Managing Employee | May 7, 2025 | 50% |
| Megan Scully | 5% Or Greater Direct Ownership Interest | Oct 7, 2024 | 6.25% |
| Corporate Director | Oct 7, 2024 | 50% | |
| Jon a Deluca | 5% Or Greater Direct Ownership Interest | Oct 7, 2024 | 12.5% |
| Corporate Director | Oct 7, 2024 | 25% | |
| Janine Witte | 5% Or Greater Direct Ownership Interest | Oct 7, 2024 | 10% |
| Jennifer Kleckner | 5% Or Greater Direct Ownership Interest | Oct 7, 2024 | 10% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Merrillville, IN
- NPI 1205981750
Contracted Managing Employee
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": "1738540800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1738540800000",
"number": "1831903723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5333 N SHERIDAN RD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606407371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5333 N SHERIDAN RD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606407371",
"telephone_number": "872-351-4991"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WILLOW BRANCH HOSPICE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-02-03",
"last_updated": "2025-02-03",
"certification_date": "2025-02-03",
"status": "A",
"authorized_official_last_name": "DELUCA",
"authorized_official_first_name": "JON",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "872-351-4991"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Willow Branch Hospice",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; 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.