Lutheran Home for Aged Development Corporation

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0018044 Issued in IL

Legal business name

LUTHERAN HOME FOR AGED DEVELOPMENT CORPORATION

Doing business as

Prairieview Lutheran Home

Practice address

403 North Fourth St.
Danforth, IL 60930

Phone

(815) 269-2970

Fax

(815) 269-2930

NPI assigned

Dec 30, 2005

Last updated

May 13, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Jo Marie Silver

Title

Administrator

Phone

(815) 269-2970

Specialties & licenses 1

Addresses

Other names 1

• Prairieview Lutheran Home Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881671741. Details of each certification follow.

• CCN 145953 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 145953

Legal name

LUTHERAN HOME FOR AGED DEVELOPMENT CORPORATION

Doing business as

PRAIRIEVIEW LUTHERAN HOME

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Feb 1, 1998

Last certification

Nov 15, 2024

Beds

90

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Jul 22, 1970 in IL

Enrollment address

403 N 4TH St
Danforth, IL 60930-5800

Nursing home name

PRAIRIEVIEW LUTHERAN HOME

Listed as

Prairieview Lutheran HomeCCN 145953 · All quality measures

Overall star rating

3 of 5

Health inspections

2 of 5

Staffing

5 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Feb 1, 1998

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

9085.1 residents per day on average

Penalties (3 years)

7Fines totaling $89,042

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

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.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Venkata Moparthi, M.D.

  • Internal Medicine Physician
  • Clifton, IL
  • NPI 1699797548

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Affiliated clinicians 6

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

• Catalino Medina Bautista Jr., M.D.

  • Family Medicine Physician
  • Watseka, IL
  • NPI 1699706101

  Nursing home

  Care Compare affiliation
• Young Jun Lee, MD

  • Family Medicine Physician
  • Watseka, IL
  • NPI 1982281978

  Nursing home

  Care Compare affiliation
• Alexander Eugene Michalow, MD

  • Orthopaedic Surgery Physician
  • Bradley, IL
  • NPI 1891703609

  Nursing home

  Care Compare affiliation
• Venkata Moparthi, M.D.

  • Internal Medicine Physician
  • Clifton, IL
  • NPI 1699797548

  Nursing home

  Care Compare affiliation
• Crisanto M Reyes, M.D.

  • Internal Medicine Physician
  • Milford, IL
  • NPI 1154461978

  Nursing home

  Care Compare affiliation
• Juan Santiago-Palma, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Bradley, IL
  • NPI 1295743953

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431475200000",
    "number": "1881671741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 NORTH FOURTH ST.",
            "city": "DANFORTH",
            "state": "IL",
            "postal_code": "60930",
            "telephone_number": "815-269-2970",
            "fax_number": "815-269-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 NORTH FOURTH ST.",
            "city": "DANFORTH",
            "state": "IL",
            "postal_code": "60930",
            "telephone_number": "815-269-2970",
            "fax_number": "815-269-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN HOME FOR AGED DEVELOPMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-30",
        "last_updated": "2015-05-13",
        "status": "A",
        "authorized_official_last_name": "SILVER",
        "authorized_official_first_name": "JO MARIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "815-269-2970",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0018044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prairieview Lutheran Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Aftab
• Kimberly L Hall, MS CCC/SLP
• Megan Ann Nephew, BSN, RN, CDP
• Janice Ian Ramos, RPT

• Skilled Nursing Facility in Danforth, IL
• Providers in Danforth, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; 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.

Verify at the official NPI Registry.