Admiral at the Lake – Skilled Nursing Facility

Key facts

NPI: 1982946604
Entity type: Organization (NPI type 2)
Primary specialty: Skilled Nursing Facility 314000000X
Legal business name: ADMIRAL AT THE LAKE
Practice address: 933 W. Foster Ave
Chicago, IL 60640
Phone: (773) 433-1800
NPI assigned: Mar 20, 2013
Organization subpart: No

Authorized official

Name: Chaim Dubovick
Title: Administrator
Phone: (773) 433-1800

Owners & managing parties with NPI records 1

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

Eric Mizuno, M.D. Internal Medicine Physician · Chicago, IL · NPI 1558398388

CMS ownership ADP OF THE SNF · OPERATIONAL/MANAGERIAL CONTROL

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

The Old People'S Home of the City of Chicago Nursing Facility/Intermediate Care Facility · Chicago, IL · NPI 1508922683

NPD tax ID

Practitioners 1

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

Helen Dittmer, MSN, DNS-CT, RN Gerontology Registered Nurse · Rockford, IL · NPI 1720657190

NPD

Affiliated clinicians 1

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

Eric Mizuno, M.D. Internal Medicine Physician · Chicago, IL · NPI 1558398388

Care Compare affiliation Nursing home

Medicare Care Compare: Nursing home

Listed as: Admiral at the Lake, the CCN 146165
Overall star rating: ★★★★☆ 4 of 5
Health inspections: ★★★★☆ 4 of 5
Staffing: ★★★★☆ 4 of 5
Quality measures: ★★★★☆ 4 of 5
Type: Medicare
Ownership: Non profit - Corporation
Certified: Oct 1, 2013
Medicare certification status: Active (Provider of Services file)
Certified beds: 36 · 28.4 residents per day on average

Source: Medicare Care Compare, processed Aug 1, 2026.

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
14D2045111	The Admiral at the Lake 933 W Foster Ave, Chicago, IL 60640	Certificate of waiver	Aug 6, 2026

Medicare participation

Medicare fee-for-service enrollment: Enrolled in IL

Skilled nursing facility certification: CCN 146165

Legal name: ADMIRAL AT THE LAKE
Certification status: Active
Provider type (POS): Nursing home – SNF (Medicare) only
Participating since: Oct 1, 2013
Last certification: Jan 24, 2025
Beds: 36
Ownership / control type: Nonprofit Corporation
Organization structure: Corporation · Non-profit
Incorporated: Jun 4, 1887 in IL
Enrollment address: 933W Foster Ave
Chicago, IL 60640-2201
Nursing home name: ADMIRAL AT THE LAKE, THE

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
Jordan Shields Individual	Corporate Director Director	Aug 1, 2018
Toni Smith Individual	Corporate Director Board Member	Jan 1, 2024
Chris G Braier Individual	Corporate Director Board Member	Jul 1, 2022
Fred Wackerle Individual	Corporate Director Board Member	Apr 1, 2017
Kate Bensen Individual	Corporate Director Board Member	Jan 1, 2022
Carol Wetmore Individual	Corporate Director Board Member	Apr 1, 2022
Kim Boike Individual	Corporate Director Board Chairman	Apr 1, 2022
Eric Mizuno Individual	Operational/Managerial Control	Jan 1, 2016
Eric Mizuno Individual	Adp of the SNF	Jan 1, 2016
Nadia N Geigler Individual	Corporate Officer Chief Executive Officer	Jan 27, 2017	100%
Nadia N Geigler Individual	Operational/Managerial Control Chief Executive Officer	Jan 27, 2017	100%
Erika Keegan Individual	Corporate Officer Chief Operating Officer	Oct 16, 2023
Toya Campbell Individual	Corporate Director Board Member	Jul 1, 2024
Justin Bhandari Individual	Corporate Director Board Member	Jan 1, 2020
Shari Daw Individual	Corporate Director Board Member	Jul 1, 2024
Nicholas Farmer Individual	Corporate Director Board Member	Oct 1, 2024
Richard Zielinski Individual	Corporate Officer Chief Financial Officer	Dec 20, 2021
Jonathan Howe Individual	Corporate Director Board Member	Jan 1, 2025
Helen Dittmer Individual	Operational/Managerial Control	Sep 1, 2024
Helen Dittmer Individual	Adp of the SNF	Mar 6, 2026
Laura McKee Individual	Corporate Director Board Member	Jan 1, 2018
Jackie Taylor Individual	Corporate Director Board Member	Apr 1, 2024

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20130521000234	IL	Part a Provider - Skilled Nursing Facility	2365680980	Practice locations: Chicago, IL

National Provider Directory

Tax ID family: Admiral at the Lake (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Skilled Nursing Facility	314000000X			Yes

Addresses

Primary practice location

933 W. Foster Ave
Chicago, IL 60640

Mailing address

929 W Foster Ave
Chicago, IL 60640-1491
Phone (773) 433-1800

Other providers in Chicago, IL

All providers in Chicago, IL · Skilled Nursing Facility in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2023. 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.