THREE CROWNS PARK – Skilled Nursing Facility, NPI 1205291457

THREE CROWNS PARK is a healthcare provider. based in Evanston, Illinois. specializing in Skilled Nursing Facility. The organization holds a License No. 0012773 (IL). The NPI Number for THREE CROWNS PARK is 1205291457

Main info

Organization
Name
THREE CROWNS PARK
NPI
1205291457
Phone
Not provided
Address
2323 MCDANIEL AVE
Authorized Official
PHILIP HEMMER EXECUTIVE DIRECTOR
Enumeration Date
15 December 2015
Last Update Date
15 December 2015
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:10State licenses:2Digital endpointsOther names

Provider Addresses for THREE CROWNS PARK

  • 2323 MCDANIEL AVE

    EVANSTON, IL 602012549

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-07-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20230720000745OSkilled Nursing FacilityILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60201)

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Reviews

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Frequently asked questions

How do payers reference THREE CROWNS PARK?
For THREE CROWNS PARK, use NPI 1205291457 as the unique 10-digit identifier.
Is there an active status for THREE CROWNS PARK?
For scheduling context, THREE CROWNS PARK is shown as active in the registry.
What expertise is attributed to THREE CROWNS PARK?
THREE CROWNS PARK's specialty line reads Skilled Nursing Facility. Clinical services aligned with this taxonomy classification.
Where in Illinois is THREE CROWNS PARK registered?
Use Evanston, Illinois as the headline location for THREE CROWNS PARK here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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