United Hospice Inc | NPI 1891229324

Key facts

NPI: 1891229324
Entity type: Organization (NPI type 2)
Primary specialty: Community Based Hospice Care Agency 251G00000X
License: 2003149 (IL)
Legal business name: UNITED HOSPICE INC
Practice address: 1420 Renaissance Dr Ste 209
Park Ridge, IL 60068-1342
Phone: (847) 779-3989
Fax: (847) 799-0304
NPI assigned: Apr 11, 2017
Organization subpart: No

Authorized official

Name: Tori F Garland
Title: Administrator
Phone: (847) 779-3989

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Solomon R Katta, M.D. Family Medicine Physician · Chicago, IL · NPI 1265668750

Medicare reassignment NPD FAMILY MEDICINE · IL
Neelu Nehls Professional Counselor · Crystal Lake, IL · NPI 1528451424

NPD

Affiliated clinicians 2

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

Solomon R Katta, M.D. Family Medicine Physician · Chicago, IL · NPI 1265668750

Care Compare affiliation Hospice
Thomas L. Michalsen, D.O. General Practice Physician · Kirkland, IL · NPI 1114947876

Care Compare affiliation Hospice

Medicare Care Compare: Hospice

Listed as: United Hospice, Inc CCN 141697
Ownership: For-Profit
Certified: Apr 16, 2018
Medicare certification status: Active (Provider of Services file)

Source: Medicare Care Compare.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
14D2124952	United Hospice Inc 1420 Renaissance Dr - Ste 209, Park Ridge, IL 60068	Certificate of waiver	Jan 26, 2027

Medicare participation

Medicare fee-for-service enrollment: Enrolled (2 enrollments) in IL

Hospice certification: CCN 141697

Legal name: UNITED HOSPICE INC
Certification status: Active
Provider type (POS): Hospice
Participating since: Apr 16, 2018
Last certification: Apr 16, 2018
Ownership / control type: Proprietary - Corporation
Organization structure: Corporation · Proprietary
Incorporated: Feb 3, 2016 in IL
Enrollment address: 1420 Renaissance Dr
Ste 209
Park Ridge, IL 60068-1342

All disclosed owners & managing parties 3

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
Lira M Sadural Individual	5% Or Greater Indirect Ownership Interest Governing Body Member	Dec 17, 2018	50%
	Corporate Officer Secretary	Dec 27, 2018
	Corporate Director	Dec 27, 2018
	W-2 Managing Employee Administrator	Mar 1, 2023
Omni Healthcare Partners Inc Organization · Park Ridge, IL Created for acquisition, Corporation, For-profit	5% Or Greater Direct Ownership Interest	Dec 17, 2018	100%
Narjisha Thowfeek Individual	5% Or Greater Indirect Ownership Interest Governing Body Member	Aug 31, 2020	50%
Narjisha Thowfeek Individual	Corporate Director Board of Director	Aug 31, 2020

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20170614002218	IL	Part a Provider - Hospice	7517235666	Practice locations: Park Ridge, IL
O20251226001844	IL	Part B Supplier - Clinic/Group Practice	7517235666	Receives reassigned benefits from 1 practitioner Practice locations: Park Ridge, IL

National Provider Directory

Locations

1420 Renaissance Dr
Ste 209
Park Ridge, IL 60068
Phone (847) 779-3989

8340 Lincoln Ave
Ste 200
Skokie, IL 60077
Phone (773) 251-2408

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Community Based Hospice Care Agency	251G00000X	2003149	IL	Yes

Addresses

Primary practice location

1420 Renaissance Dr Ste 209
Park Ridge, IL 60068-1342

Mailing address

1420 Renaissance Dr Ste 209
Park Ridge, IL 60068-1342
Phone (847) 779-3989

Other providers in Park Ridge, IL

All providers in Park Ridge, IL · Community Based Hospice Care Agency in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
Provider of Services files (CMS): certification status, beds and related CCNs.
Medicare Care Compare provider data (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.