KENWOOD VILLAGE NURSING AND REHABILITATION CENTER, LLC
NPI 1740023126
Skilled Nursing Facility in Chicago, IL

Active since June 14, 2024CLIA 14D0428521 · Waiver
4505 S DREXEL BLVD, CHICAGO, IL 60653(773) 285-0550 Get Directions Write a Review

NPPES record last updated: June 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 11, 2025, Jul 3, 2024, Jun 14, 2024 (3 updates tracked since 2024).

About Kenwood Village Nursing And Rehabilitation Center, Llc NPPES

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

KENWOOD VILLAGE NURSING AND REHABILITATION CENTER, LLC (NPI 1740023126) is a healthcare organization registered as a skilled nursing facility in Chicago, Illinois and active in the NPI registry since June 2024. The organization holds a CLIA Waiver certificate valid through June 15, 2027 and lists Jake Mashiach, Authorized Signatory, as its authorized official.

NPPES Registry Identity

NPI1740023126
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameKENWOOD VILLAGE NURSING AND REHABILITATION CENTER, LLC
Location Address4505 S DREXEL BLVDChicago, IL 60653-4301
Mailing Address7434 Skokie BlvdSkokie, IL 60077-3341
Organization SubpartNo
Authorized OfficialJake MashiachAuthorized Signatory · (773) 285-0550
Enumeration DateJune 14, 2024
Last NPPES UpdateJune 11, 20253 updates tracked since enumeration
NPPES CertifiedJune 11, 2025
NPI 1740023126 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.
4505 S DREXEL BLVD, Chicago, IL 60653

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 14D0428521

Kenwood Village · Chicago, IL
Active · expires Jun 15, 2027
CLIA Number14D0428521
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateJune 16, 2025
Certificate Expiration DateJune 15, 2027
Laboratory DirectorDianne C. Oconnor
Laboratory Phone(773) 285-0550
Laboratory LocationKenwood Village4505 S Drexel Blvd, Chicago, IL 60653
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 11

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

Social Worker (Clinical)
4505 S DREXEL BLVD
CHICAGO, IL 60653
Skilled Nursing Facility
4505 S DREXEL BLVD
CHICAGO, IL 60653
Speech-Language Pathologist
4505 S DREXEL BLVD
CHICAGO, IL 60653
Speech-Language Pathologist
4505 S DREXEL BLVD
CHICAGO, IL 60653
Skilled Nursing Facility
4505 S DREXEL BLVD
CHICAGO, IL 60653
Nurse Practitioner
4505 S DREXEL BLVD
CHICAGO, IL 60653
Skilled Nursing Facility
4505 S DREXEL BLVD
CHICAGO, IL 60653
Occupational Therapist
4505 S DREXEL BLVD
CHICAGO, IL 60653

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 Kenwood Village Nursing And Rehabilitation Center, LLC's NPI number?

The NPI number for Kenwood Village Nursing And Rehabilitation Center, LLC is 1740023126. It was assigned to this organization in the NPPES registry on June 14, 2024.

Where is Kenwood Village Nursing And Rehabilitation Center, LLC located?

Kenwood Village Nursing And Rehabilitation Center, LLC is located at 4505 S Drexel Blvd, Chicago, IL 60653. The listed phone number is (773) 285-0550.

What is Kenwood Village Nursing And Rehabilitation Center, LLC's specialty?

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

Does Kenwood Village Nursing And Rehabilitation Center, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0428521) is associated with this NPI, valid through June 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Kenwood Village Nursing And Rehabilitation Center, LLC accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Kenwood Village Nursing And Rehabilitation Center, 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 Kenwood Village Nursing And Rehabilitation Center, LLC was last updated on June 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.