NPIMap

Organization Active NPI

Lighthouse Hospice Care LLC

  • Community Based Hospice Care Agency
  • Naperville, IL
National Provider Identifier
1982204699
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
LIGHTHOUSE HOSPICE CARE LLC
Practice address
648 N River Rd Ste 100
Naperville, IL 60563-8968
Phone
(331) 472-4706
Fax
(331) 472-4707
NPI assigned
Oct 30, 2020
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Christopher Vangel
Title
President
Phone
(331) 472-4706

Facilities with the same owner 1

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

Practitioners 1

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

Affiliated clinicians 35

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

View all 35

Care Compare: Hospice

Medicare Care Compare
Listed as
Lighthouse Hospice Care LLCCCN 141713
Ownership
For-Profit
Certified
Aug 24, 2021
Medicare certification status
ActiveFrom the Provider of Services file

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
14D2209249Lighthouse Hospice Care, L L C648 N River Rd - Ste 100, Naperville, IL 60563Certificate of waiverJan 11, 2027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210505000067 IL Part A Provider - Hospice 8729497789 Practice locations: Downers Grove, IL
O20221115000202 IL Part B Supplier - Clinic/Group Practice 8729497789 Receives reassigned benefits from 1 practitioner
Practice locations: Downers Grove, IL

Hospice certification: CCN 141713

Legal name
LIGHTHOUSE HOSPICE CARE LLC
Doing business as
LIGHTHOUSE HOSPICE AND PALLIATIVE CARE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 24, 2021
Last certification
Aug 24, 2021
Ownership / control type
Proprietary - Partnership
Organization structure
LLCProprietary
Incorporated
Aug 3, 2020 in DE
Enrollment address
2807 Centre Cir
Downers Grove, IL 60515-1030

All disclosed owners & managing parties 5

Medicare enrollment files

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

NameRoleSinceShare
Robert Bahram Jafari 2002 Irrevocable Trust Organization, Downers Grove, IL 5% Or Greater Indirect Ownership Interest Aug 3, 2020 50%
Pchrj LLC Organization, Downers Grove, IL LLC, For-profit 5% Or Greater Direct Ownership Interest Aug 3, 2020 50%
Christopher P Vangel Individual Corporate OfficerPresident Aug 3, 2020
Corporate DirectorManaging Member Aug 3, 2020
W-2 Managing EmployeePresident Aug 3, 2020
Robert B Jafari Individual Corporate DirectorManaging Member Aug 3, 2020
Chris Vangel GST Exempt Descendants Trust Organization, Downers Grove, IL 5% Or Greater Direct Ownership Interest Aug 3, 2020 50%

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

648 N River Rd Ste 100
Naperville, IL 60563-8968

Mailing address

648 N River Rd Ste 100
Naperville, IL 60563-8968
Phone (331) 472-4706

Other names 1

NPPES NPI Registry
  • Lighthouse Hospice and Palliative Care Doing business as

Electronic endpoints 2

NPPES NPI Registry
TypeEndpointUseAffiliation
Direct Messaging Address info@lighthousehospice.com Direct
Other URL PERSONALDOMAIN Health Information Exchange (HIE)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 30, 2020.

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604016000000",
    "number": "1982204699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 N RIVER RD STE 100",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638968",
            "telephone_number": "331-472-4706",
            "fax_number": "331-472-4707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 N RIVER RD STE 100",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638968",
            "telephone_number": "331-472-4706",
            "fax_number": "331-472-4707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE HOSPICE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-30",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A",
        "authorized_official_last_name": "VANGEL",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "331-472-4706",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@lighthousehospice.com",
            "affiliation": "N",
            "endpointDescription": "Computer",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "648 N River Rd Ste 100",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605638968",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "PERSONALDOMAIN",
            "affiliation": "N",
            "endpointDescription": "GODADDY URL",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EMAIL-WEBSITE-DOMAIN",
            "address_1": "648 N River Rd Ste 100",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605638968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Lighthouse Hospice and Palliative Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.