NPIMap

Organization Active NPI

Alden Courts of Waterford, L.L.C.

  • Skilled Nursing Facility
  • Chicago, IL
National Provider Identifier
1851849269
Registry record updated Jul 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
ALDEN COURTS OF WATERFORD, L.L.C.
Practice address
4200 W. Peterson Ave. Suite 140
Chicago, IL 60646-6074
Phone
(773) 286-6622
NPI assigned
Sep 14, 2016
Last updated
Jul 18, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2017

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

Authorized official

Name
John Avelino
Title
Accounts Receivable Manager
Phone
(773) 724-6376

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NU
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

4200 W. Peterson Ave. Suite 140
Chicago, IL 60646-6074

Mailing address

1991 Randi Dr
Aurora, IL 60504-4757
Phone (630) 851-1466

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170112000681 IL Part A Provider - Skilled Nursing Facility 6002197795 Practice locations: Aurora, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851849269. Details of each certification follow.

Skilled nursing facility certification: CCN 146182

Legal name
ALDEN COURTS OF WATERFORD LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 20, 2017
Last certification
Aug 28, 2024
Beds
60
Ownership / control type
Corporation
Multi-facility organization
Alden Managment Services
Organization structure
LLCProprietary
Incorporated
Oct 13, 1999
Enrollment address
1991 Randi Dr
Aurora, IL 60504-4757
Nursing home name
ALDEN COURTS OF WATERFORD
Affiliated entity
THE ALDEN NETWORK

Care Compare: Nursing home

Medicare Care Compare
Listed as
Alden Courts of WaterfordCCN 146182 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Mar 20, 2017
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6056.4 residents per day on average
Chain
The Alden Network27 facilities in the chain
Penalties (3 years)
1Fines totaling $21,645

Processed by Care Compare on Aug 1, 2026.

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
14D2124065Alden Courts of Waterford1991 Randi Dr, Aurora, IL 60504Certificate of waiverJan 8, 2027

National Provider Directory

National Provider Directory

Locations

1991 Randi Dr
Aurora, IL 60504
Phone (630) 851-1466

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Veneranda G Tabieros Individual W-2 Managing EmployeeDirector of Nursing Jan 18, 2017 100%
Alden of Waterford Investments LLC Organization, Chicago, IL LLC 5% Or Greater Direct Ownership Interest Oct 13, 1999 100%
Joan P Carl Individual OtherCo Manager of LLC Oct 13, 1999 100%
Alden Management Services, Inc. Organization, Chicago, IL Corporation Operational/Managerial Control Jan 18, 2017
Esther J Davis Individual Contracted Managing Employee Mar 15, 2010
Steven M Kroll Individual Contracted Managing Employee Dec 6, 2001 2%
The Alden Group, LTD. Organization, Chicago, IL Corporation 5% Or Greater Indirect Ownership Interest Oct 13, 1999 64.31%
Lauren a Wetzel Individual W-2 Managing EmployeeAdministrator Jan 18, 2017 100%
The Floyd a. Schlossberg Living Trust Organization, Chicago, IL 5% Or Greater Indirect Ownership Interest Oct 13, 1999 35.69%
Audra B Elisco Individual 5% Or Greater Indirect Ownership Interest Jul 1, 2013 13.36%
Lauren H Magnusson Individual 5% Or Greater Indirect Ownership Interest Jul 1, 2013 13.36%
Randi Schullo Individual 5% Or Greater Indirect Ownership Interest Jul 1, 2013 13.36%

Facilities with the same owner 28

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

View all 28

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1473811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500336000000",
    "number": "1851849269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1991 RANDI DR",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605044757",
            "telephone_number": "630-851-1466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 W. PETERSON AVE. SUITE 140",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606466074",
            "telephone_number": "773-286-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALDEN COURTS OF WATERFORD, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-14",
        "last_updated": "2017-07-18",
        "status": "A",
        "authorized_official_last_name": "AVELINO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "ACCOUNTS RECEIVABLE MANAGER",
        "authorized_official_telephone_number": "773-724-6376"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.