NPIMap

Organization Active NPI

South Holland Manor HRC LLC

  • Skilled Nursing Facility
  • South Holland, IL
National Provider Identifier
1922575752
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SOUTH HOLLAND MANOR HRC LLC
Practice address
2145 E 170TH St
South Holland, IL 60473-3788
Phone
(708) 895-3255
NPI assigned
Oct 30, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Authorized official

Name
Mr. Levi Israel
Title
Ceo
Phone
(847) 905-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

2145 E 170TH St
South Holland, IL 60473-3788

Mailing address

2201 Main St
Evanston, IL 60202-1519
Phone (847) 905-3000

Other identifiers 1

IdentifierTypeStateIssuer
0055053OtherILIL DEPARTMENT OF PUBLIC HEALTH

Other names 1

  • South Holland Manor Health & Rehab Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181129000346 IL Part A Provider - Skilled Nursing Facility 4587908710 Practice locations: South Holland, IL

Skilled nursing facility certification: CCN 145608

Legal name
SOUTH HOLLAND MANOR HRC LLC
Doing business as
SOUTH HOLLAND MANOR HEALTH AND REHAB CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 23, 1989
Last certification
Aug 16, 2024
Beds
216
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Enrollment address
2145 East 170TH Street
South Holland, IL 60473-3788
Nursing home name
THRYVE OF SOUTH HOLLAND
Affiliated entity
ALIYA HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Thryve of South HollandCCN 145608
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
Feb 23, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
216132.4 residents per day on average
Chain
Aliya Healthcare14 facilities in the chain
Penalties (3 years)
2Fines totaling $35,640

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
14D0674703South Holland Manor Health & Rehab2145 E 170TH St, South Holland, IL 60473Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Extended Care Clinical LLC Organization, Evanston, IL LLC Adp of the SNF Nov 1, 2018
Atied Associates LLC Organization, Evanston, IL LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Nov 1, 2018 100%
Adp of the SNF Nov 1, 2018
William Rothner Individual Corporate Director Nov 1, 2018
Roth & Co, LLP Organization, Brooklyn, NY Adp of the SNF Jan 8, 2024
Extended Care Consulting LLC Organization, Evanston, IL LLC Adp of the SNF Nov 1, 2018
Nichole Cole Individual Operational/Managerial Control Aug 7, 2023
Adp of the SNF Aug 7, 2023
Levi Israel Individual Corporate OfficerCeo Jan 1, 2023
Anthony del Priore Individual Adp of the SNF Jul 31, 2019

Owners & managing parties with NPI records 1

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

Facilities with the same owner 40

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

View all 40

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1540857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1922575752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 MAIN ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021519",
            "telephone_number": "847-905-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 E 170TH ST",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604733788",
            "telephone_number": "708-895-3255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH HOLLAND MANOR HRC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-30",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A",
        "authorized_official_last_name": "ISRAEL",
        "authorized_official_first_name": "LEVI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "847-905-3000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL DEPARTMENT OF PUBLIC HEALTH",
            "identifier": "0055053",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Holland Manor Health & Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Holland Manor Health & Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Holland, IL

Sources for this page

Verify at the official NPI Registry.