PAVILION OF OTTAWA LLC
NPI 1306584958
Skilled Nursing Facility in Ottawa, IL

Active since May 24, 2022CLIA 16D0673461 · Waiver
4/5
Overall Rating
704 E GLOVER ST, OTTAWA, IL 61350(815) 434-7144(815) 434-2376 Get Directions Write a Review

NPPES record last updated: November 4, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 4, 2025, May 24, 2022 (2 updates tracked since 2022).

About Pavilion Of Ottawa Llc NPPES

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

PAVILION OF OTTAWA LLC (NPI 1306584958), doing business as Pavilion Of Ottawa, is a healthcare organization registered as a skilled nursing facility in Ottawa, Illinois and active in the NPI registry since May 2022. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Marcella Graf, Cfo, as its authorized official.

NPPES Registry Identity

NPI1306584958
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NamePAVILION OF OTTAWA LLC
Location Address704 E GLOVER STOttawa, IL 61350-4131
Mailing Address3755 Chase AveSkokie, IL 60076-4008 · (224) 470-2044 · Fax (224) 470-2952
Fax(815) 434-2376
Organization SubpartNo
Authorized OfficialMarcella GrafCfo · (224) 470-2044
Enumeration DateMay 24, 2022
Last NPPES UpdateNovember 4, 20252 updates tracked since enumeration
NPPES CertifiedNovember 4, 2025
NPI 1306584958 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
704 E GLOVER ST, Ottawa, IL 61350

Other Names 1

Doing Business AsPavilion Of Ottawa

Other Identifiers 1

Medicaid6006985IL

Accepted Insurance

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 16D0673461

Pavilion Of Ottawa · Ottawa, IL
Active · expires Aug 31, 2026
CLIA Number16D0673461
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorLauren Mattes
Laboratory Phone(815) 431-4900
Laboratory LocationPavilion Of Ottawa704 E Glover, Ottawa, IL 61350
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Pavilion Of Ottawa (CMS certification number 145426), from CMS Care Compare.

Pavilion Of Ottawa

Nursing home · Ottawa, IL
4/5 CMS Overall Rating
OwnershipFor profit - Limited Liability company
CMS Certification Number145426
Certified Beds135 beds126 residents per day on average
Medicare & Medicaid Participant SinceJune 4, 1981
Resident & Family CouncilResident council
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
4/5
Long-Stay Quality
Quality of care delivered to long-term residents.
4/5
Short-Stay Quality
Quality of care delivered to short-term and rehabilitation residents.
4/5
Staffing
Based on nursing staff hours relative to resident needs.
2/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
34.67
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 2.4 · LPN 0.43 · RN 0.64
3.48 hrs per resident per day
Weekend Nurse Staffing
3.17 hrs per resident per day
Physical Therapist Staffing
0.02 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
36%
Registered Nurse Turnover
40%
Administrators Who Have Left
In the past year.
0
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
0
Substantiated Complaints
4
Fines
0
Medicare Payment Denials
1
Total Penalties
1
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Other Providers at the Same Location NPPES

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

Skilled Nursing Facility
704 E GLOVER ST
OTTAWA, IL 61350

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 Pavilion Of Ottawa LLC's NPI number?

The NPI number for Pavilion Of Ottawa LLC is 1306584958. It was assigned to this organization in the NPPES registry on May 24, 2022. The provider is doing business as Pavilion of Ottawa.

Where is Pavilion Of Ottawa LLC located?

Pavilion Of Ottawa LLC is located at 704 E Glover St, Ottawa, IL 61350. The listed phone number is (815) 434-7144.

What is Pavilion Of Ottawa LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Pavilion Of Ottawa LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 16D0673461) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Pavilion Of Ottawa LLC a Medicare-certified nursing home?

Yes. Pavilion Of Ottawa is a Medicare-certified nursing home with 135 certified beds.

What quality rating does Pavilion Of Ottawa LLC have?

CMS rates Pavilion Of Ottawa 4 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

What insurance does Pavilion Of Ottawa LLC accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health and Quartz list Pavilion Of Ottawa LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pavilion Of Ottawa LLC was last updated on November 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.