SUNRISE OF FLOSSMOOR
NPI 1013188861
Assisted Living Facility in Flossmoor, IL

Q: What is Sunrise Third (pool 1), LLC.'s NPI number?

The NPI number for Sunrise Third (pool 1), LLC. is 1013188861. It was assigned to this organization in the NPPES registry on March 20, 2008. The provider is doing business as Sunrise Of Flossmoor.

Q: What is Sunrise Third (pool 1), LLC.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since March 20, 2008CLIA 14D2089502 · Waiver

19715 GOVERNORS HWY, FLOSSMOOR, IL 60422(708) 798-1600(708) 798-3406 Get Directions Write a Review

NPPES record last updated: March 20, 2008. Verified against the NPPES registry weekly; last sync: September 27, 2026.

On this page

About Sunrise Of Flossmoor NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUNRISE OF FLOSSMOOR (NPI 1013188861) is a healthcare organization registered as an assisted living facility in Flossmoor, Illinois and active in the NPI registry since March 2008. The organization holds a CLIA Waiver certificate valid through December 30, 2026 and lists Brian Gename, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1013188861

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameSUNRISE THIRD (POOL 1), LLC.

Location Address19715 GOVERNORS HWYFlossmoor, IL 60422-1794

Mailing Address19715 Governors HwyFlossmoor, IL 60422-1794 · (708) 798-1600 · Fax (708) 798-3406

Phone(708) 798-1600

Fax(708) 798-3406

Organization SubpartNo

Authorized OfficialBrian GenameExecutive Director · (708) 798-1600

Enumeration DateMarch 20, 2008

✔ NPI 1013188861 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

19715 GOVERNORS HWY, Flossmoor, IL 60422

Open in Google Maps ↗

Other Names 1

Doing Business AsSunrise Of Flossmoor

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2089502

Sunrise Of Flossmoor · Flossmoor, IL

Active · expires Dec 30, 2026

CLIA Number14D2089502

Laboratory TypeAssisted Living Facility

Certificate Effective DateDecember 31, 2024

Certificate Expiration DateDecember 30, 2026

Laboratory DirectorAnjenette L. Campbell

Laboratory Phone(708) 798-1600

Laboratory LocationSunrise Of Flossmoor19715 Governors Hwy, Flossmoor, IL 60422

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. KYLIE ALICIA OLSON MS, OTR/L

Occupational Therapist

19715 GOVERNORS HWY
FLOSSMOOR, IL 60422

Cook County (708) 798-1600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sunrise Third (pool 1), LLC.'s NPI number?

The NPI number for Sunrise Third (pool 1), LLC. is 1013188861. It was assigned to this organization in the NPPES registry on March 20, 2008. The provider is doing business as Sunrise Of Flossmoor.

Where is Sunrise Third (pool 1), LLC. located?

Sunrise Third (pool 1), LLC. is located at 19715 Governors Hwy, Flossmoor, IL 60422. The listed phone number is (708) 798-1600.

What is Sunrise Third (pool 1), LLC.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Sunrise Third (pool 1), LLC. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2089502) is associated with this NPI, valid through December 30, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Sunrise Third (pool 1), LLC. was last updated on March 20, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.