NPIMap

Organization Active NPI

Orland Park Skilled Nursing Facility LLC

  • Skilled Nursing Facility
  • Orland Park, IL
National Provider Identifier
1861075152
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
ORLAND PARK SKILLED NURSING FACILITY LLC
Practice address
14601 John Humphrey Dr
Orland Park, IL 60462-2641
Phone
(708) 349-8300
Fax
(708) 349-4093
NPI assigned
May 4, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Authorized official

Name
Mordechay Ninio
Title
Cfo
Phone
(847) 676-5315

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

14601 John Humphrey Dr
Orland Park, IL 60462-2641

Mailing address

3450 Oakton St
Skokie, IL 60076-2951
Phone (847) 679-9797

Other names 1

  • Warren Barr Orland Park Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210624002654 IL Part A Provider - Skilled Nursing Facility 5799186953 Practice locations: Orland Park, IL

Skilled nursing facility certification: CCN 145899

Legal name
ORLAND PARK SKILLED NURSING FACILITY LLC
Doing business as
WARREN BARR ORLAND PARK
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 23, 1996
Last certification
Apr 11, 2025
Beds
275
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Legacy Healthcare
Most recent change of ownership
Jun 1, 2021
Organization structure
LLCProprietary
Incorporated
in IL
Enrollment address
14601 John Humphrey Dr
Orland Park, IL 60462-2641
Nursing home name
WARREN BARR ORLAND PARK
Affiliated entity
LEGACY HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Warren Barr Orland ParkCCN 145899
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Aug 23, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
275187.1 residents per day on average
Chain
Legacy Healthcare89 facilities in the chain
Penalties (3 years)
4Fines totaling $60,348

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Scott Morton Individual W-2 Managing EmployeeAdministrator Jun 1, 2021
Mordechay Ninio Individual 5% Or Greater Direct Ownership Interest Jun 1, 2021 58.5%
Tbdmd Il, LLC Organization, Skokie, IL LLC, For-profit Operational/Managerial Control Jun 1, 2021
Daniel Garden Individual 5% Or Greater Direct Ownership Interest Jun 1, 2021 7.5%
GPN Family Trust U/a/D 4/28/08 Organization, Skokie, IL 5% Or Greater Direct Ownership Interest Jun 1, 2021 17%
Doros Generation Trust U/a/D 1/3/12 Organization, Skokie, IL 5% Or Greater Direct Ownership Interest Jun 1, 2021 17%

Facilities with the same owner 84

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

View all 84

Practitioners & affiliated clinicians

Affiliated clinicians 5

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": "1620086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624233600000",
    "number": "1861075152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 OAKTON ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762951",
            "telephone_number": "847-679-9797",
            "fax_number": "847-679-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14601 JOHN HUMPHREY DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622641",
            "telephone_number": "708-349-8300",
            "fax_number": "708-349-4093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORLAND PARK SKILLED NURSING FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-04",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A",
        "authorized_official_last_name": "NINIO",
        "authorized_official_first_name": "MORDECHAY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "847-676-5315"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Warren Barr Orland Park",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Warren Barr Orland Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.