Active NPI
Shelbyville Healthcare & Senior Living LLC
- Skilled Nursing Facility
- Shelbyville, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- SHELBYVILLE HEALTHCARE & SENIOR LIVING LLC
- Practice address
- 2116 W South 3Rd St
Shelbyville, IL 62565-9102 - Phone
- (217) 774-2128
- NPI assigned
- Nov 4, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kevin Chankin
- Title
- Authorized Official
- Phone
- (773) 745-1107
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | |||
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
2116 W South 3Rd St
Shelbyville, IL 62565-9102
Mailing address
8153 Lawndale Ave
Skokie, IL 60076-3321
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250203000324 | IL | Part A Provider - Skilled Nursing Facility | 4981133139 | Practice locations: Shelbyville, IL |
Skilled nursing facility certification: CCN 145836
- Legal name
- SHELBYVILLE HEALTHCARE & SENIOR LIVING LLC
- Doing business as
- SHELBYVILLE HEALTHCARE & SENIOR LIVING
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Jun 1, 1995
- Last certification
- Aug 9, 2024
- Beds
- 80
- Ownership / control type
- Corporation
- Multi-facility organization
- Lincoln Health Care
- Organization structure
- LLC
- Enrollment address
- 2116 W South 3Rd St
Dacey Drive
Shelbyville, IL 62565-9102 - Nursing home name
- SHELBYVILLE HEALTHCARE & SENIOR LIVING
- Affiliated entity
- POINTE MANAGEMENT
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Shelbyville Healthcare & Senior Living
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jun 1, 1995
- Medicare certification status
- Active
- Certified beds
- 80
- Chain
- Pointe Management
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D0435275 | Shelbyville Healthcare & Senior Living | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 19
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 |
|---|---|---|---|
| Afmzl, LLC | 5% Or Greater Indirect Ownership Interest | Dec 1, 2024 | 25% |
| Shimon Webster | 5% Or Greater Indirect Ownership Interest | Dec 1, 2024 | 18.35% |
| Operational/Managerial Control | Dec 1, 2024 | ||
| Adp of the SNF | Dec 1, 2024 | ||
| Aharon Weiss | 5% Or Greater Indirect Ownership Interest | Dec 1, 2024 | 25% |
| Operational/Managerial Control | Dec 1, 2024 | ||
| Adp of the SNF | Dec 1, 2024 | ||
| Adp of the SNF | Dec 1, 2024 | ||
| David Oligschlaeger | Operational/Managerial Control | Dec 1, 2024 | |
| Adp of the SNF | Dec 1, 2024 | ||
| Yeruchom Levovitz | 5% Or Greater Indirect Ownership Interest | Dec 1, 2024 | 18.35% |
| Operational/Managerial Control | Dec 1, 2024 | ||
| Adp of the SNF | Dec 1, 2024 | ||
| Plante & Moran PLLC | Adp of the SNF | Dec 1, 2024 | |
| Ecapital Healthcare Corp | 5% Or Greater Security Interest | Dec 1, 2024 | 100% |
| Operational/Managerial Control | Dec 1, 2024 | ||
| Lincoln Healthcare Group, LLC | Operational/Managerial Control | Dec 1, 2024 | |
| Adp of the SNF | Dec 1, 2024 | ||
| Adp of the SNF | Apr 8, 2025 | ||
| Linicare Holdco LLC | 5% Or Greater Direct Ownership Interest | Dec 1, 2024 | 99.99% |
| Operational/Managerial Control | Dec 1, 2024 | ||
| Adp of the SNF | Dec 1, 2024 | ||
| Avrohom Ribiat | 5% Or Greater Indirect Ownership Interest | Dec 1, 2024 | 25% |
| Adp of the SNF | Dec 1, 2024 | ||
| Amanda Spade | Operational/Managerial Control | Dec 1, 2024 | |
| Adp of the SNF | Dec 1, 2024 | ||
| Kevin Chankin | 5% Or Greater Indirect Ownership Interest | Dec 1, 2024 | 10% |
| Managing Control - Governing Body | Dec 1, 2024 | ||
| Direct Ownership Interest | Dec 1, 2024 | 0.01% | |
| Stonewall HCG LLC | 5% Or Greater Indirect Ownership Interest | Dec 1, 2024 | 25% |
| Tyler Doughty | Operational/Managerial Control | Dec 1, 2024 | |
| Adp of the SNF | Dec 1, 2024 | ||
| S & C Holdings Illinois LLC | 5% Or Greater Indirect Ownership Interest | Dec 1, 2024 | 36.7% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Shelbyville, IL
- NPI 1851383418
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 24
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Barry, IL
- NPI 1558075630
S & C Holdings Illinois LLC
-
- Skilled Nursing Facility
- Carlyle, IL
- NPI 1891462768
Stonewall HCG LLC
-
- Skilled Nursing Facility
- Sullivan, IL
- NPI 1013730589
Ecapital Healthcare Corp, Linicare Holdco LLC
-
- Skilled Nursing Facility
- Effingham, IL
- NPI 1699598177
Afmzl, LLC, Ecapital Healthcare Corp, Linicare Holdco LLC
-
- Skilled Nursing Facility
- Collinsville, IL
- NPI 1336969823
Ecapital Healthcare Corp
-
- Skilled Nursing Facility
- Jerseyville, IL
- NPI 1841010337
Ecapital Healthcare Corp
-
- Skilled Nursing Facility
- Swansea, IL
- NPI 1770303265
Ecapital Healthcare Corp
-
- Skilled Nursing Facility
- Bridgeport, IL
- NPI 1992524060
Ecapital Healthcare Corp
Practitioners & affiliated clinicians
Affiliated clinicians 1
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": "1730678400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1742515200000",
"number": "1962225458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8153 LAWNDALE AVE",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600763321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2116 W SOUTH 3RD ST",
"city": "SHELBYVILLE",
"state": "IL",
"postal_code": "625659102",
"telephone_number": "217-774-2128"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHELBYVILLE HEALTHCARE & SENIOR LIVING LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-11-04",
"last_updated": "2025-03-21",
"certification_date": "2025-03-21",
"status": "A",
"authorized_official_last_name": "CHANKIN",
"authorized_official_first_name": "KEVIN",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "773-745-1107"
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": null,
"license": null,
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Shelbyville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; 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.