NPIMap

Organization Active NPI

Butterfield Skilled Nursing Facility LLC

Doing business as Bella Terra Elmhurst

  • Skilled Nursing Facility
  • Elmhurst, IL
National Provider Identifier
1942883210
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
BUTTERFIELD SKILLED NURSING FACILITY LLC
Doing business as
Bella Terra Elmhurst
Practice address
420 W Butterfield Rd
Elmhurst, IL 60126-4980
Phone
(630) 832-2300
Fax
(630) 832-7043
NPI assigned
May 4, 2021
Last updated
Jun 21, 2021By the provider in NPPES
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 NU Primary

Addresses

Primary practice location

420 W Butterfield Rd
Elmhurst, IL 60126-4980

Mailing address

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

Other names 1

  • Bella Terra Elmhurst Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210624000624 IL Part A Provider - Skilled Nursing Facility 0244631554 Practice locations: Elmhurst, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942883210. Details of each certification follow.

Skilled nursing facility certification: CCN 145711

Legal name
BUTTERFIELD SKILLED NURSING FACILITY LLC
Doing business as
BELLA TERRA ELMHURST
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Jan 6, 1992
Last certification
Mar 14, 2024
Beds
145 (142 certified)
Ownership / control type
Corporation
Multi-facility organization
Legacy Healthcare
Organization structure
LLCProprietary
Enrollment address
420 W Butterfield Rd
Elmhurst, IL 60126-4980
Nursing home name
BELLA TERRA ELMHURST
Affiliated entity
LEGACY HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Bella Terra ElmhurstCCN 145711 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 6, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
142101.5 residents per day on average
Chain
Legacy Healthcare89 facilities in the chain

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
14D2307953Bella Terra Elmhurst420 W Butterfield Rd, Elmhurst, IL 60126Certificate of waiverJul 17, 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
Mordechay Ninio Individual 5% Or Greater Direct Ownership Interest Jun 1, 2021 58.5%
Tbdmd Il, LLC Organization, Skokie, IL LLC 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%
Tremaine Brown Individual W-2 Managing EmployeeAdministrator Jun 1, 2021

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 9

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": "1942883210",
    "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": "847-676-5348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W BUTTERFIELD RD",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601264980",
            "telephone_number": "630-832-2300",
            "fax_number": "630-832-7043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUTTERFIELD 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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bella Terra Elmhurst",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bella Terra Elmhurst",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elmhurst, IL

Sources for this page

Verify at the official NPI Registry.