| Entity Name: | AMBASSADOR NURSING AND REHABILITATION CENTER II, LLC |
| Jurisdiction: | Illinois |
| Entity Type: | Limited Liability Company |
| Status: | Goodstanding |
| Date Formed: | 06 Aug 2007 |
| Company Number: | LLC_02290774 |
| File Number: | 02290774 |
| Type of Management: | Manager Managed |
| Date Status Change: | 29 Jul 2024 |
| Address | 4900 NORTH BERNARD STREET, CHICAGO, 60625, IL |
| Place of Formation: | ILLINOIS |
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MEC1WHD3WNF6 | 2025-03-26 | 4900 N BERNARD ST, CHICAGO, IL, 60625, 5146, USA | 240 FENCL LANE, HILLSIDE, IL, 60162, USA | |||||||||||||||||||||||||||||||||||||||||||
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| Doing Business As | AMBASSADOR NURSING & REHABILITATION CENTER |
| Division Name | THE WATERS OF WINCHESTER |
| Congressional District | 03 |
| State/Country of Incorporation | IL, USA |
| Activation Date | 2024-03-28 |
| Initial Registration Date | 2024-03-26 |
| Entity Start Date | 2007-08-06 |
| Fiscal Year End Close Date | Dec 31 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | THE WATERS OF WINCHESTER |
| Role | STAFF ACCOUNTANT |
| Address | 240 FENCL LANE, HILLSIDE, IL, 60162, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | THE WATERS OF WINCHESTER |
| Role | STAFF ACCOUNTANT |
| Address | 240 FENCL LANE, HILLSIDE, IL, 60162, USA |
| Past Performance | Information not Available |
|---|
| Name and Address | Role | Appointment Date |
|---|---|---|
| CARRIE DIPAOLO, 240 FENCL LN, HILLSIDE, 60162, COOK-NOT IN CITY OF CHICAGO | Agent | 2020-05-08 |
| Name and Address | Role | Appointment Date |
|---|---|---|
| GUBIN, MOISHE, 1230 RIDGEDALE ROAD, SOUTH BEND, IN, 46614 | Manager | 2024-07-29 |
| BLISKO, MICHAEL, 2909 W FITCH AVE, CHICAGO, IL, 60645 | Manager | 2024-07-29 |
| Name and Address | Role | Account Number |
|---|---|---|
| MICHAEL BLISKO | Managing member | 333013 |
| MOISHE GUBIN | Managing member | 333013 |
| Name and Address | Role | Account Number |
|---|---|---|
| Y & B INVESTMENTS, LLC | Shareholder | 333013 |
| License Type | License Number | Status | License Code | License Description | Business Activity | Date Issued | Effective Date | Expiration Date |
|---|---|---|---|---|---|---|---|---|
| BUSINESS LICENSE | 2207938 | Issued | 4404 | Regulated Business License | 699 - Long Term Care Facility | 2023-09-12 | 2023-09-16 | 2025-09-15 |
| BUSINESS LICENSE | 1914230 | Cancelled | 1005 | Long-Term Care Facility | No data | 2011-11-16 | 2011-09-16 | 2013-09-15 |
| Inspection ID | Inspection Type | Inspection Date | License | Facility Type | Address | Risk | Results |
|---|---|---|---|---|---|---|---|
| 2603022 | Canvass Re-Inspection | 2024-09-18 | 2207938 | Long Term Care | 4900 N BERNARD ST, CHICAGO, IL, 60625 | Risk 1 (High) | Pass |
| 2602431 | Canvass | 2024-09-10 | 2207938 | Long Term Care | 4900 N BERNARD ST, CHICAGO, IL, 60625 | Risk 1 (High) | Fail |
| 2579959 | Canvass | 2023-08-11 | 2207938 | Long Term Care | 4900 N BERNARD ST, CHICAGO, IL, 60625 | Risk 1 (High) | Pass |
| 2561261 | Canvass | 2022-07-26 | 2207938 | Long Term Care | 4900 N BERNARD ST, CHICAGO, IL, 60625 | Risk 1 (High) | Pass |
| 2523716 | Canvass Re-Inspection | 2021-08-06 | 2207938 | Long Term Care | 4900 N BERNARD ST, CHICAGO, IL, 60625 | Risk 1 (High) | Pass w/ Conditions |
| 2522856 | Canvass | 2021-07-19 | 2207938 | Long Term Care | 4900 N BERNARD ST, CHICAGO, IL, 60625 | Risk 1 (High) | Fail |
| 2300802 | Canvass Re-Inspection | 2019-07-09 | 2207938 | Long Term Care | 4900 N BERNARD ST, CHICAGO, IL, 60625 | Risk 1 (High) | Pass |
| 2300422 | Canvass | 2019-06-28 | 2207938 | Long Term Care | 4900 N BERNARD ST, CHICAGO, IL, 60625 | Risk 1 (High) | Fail |
| 2170053 | Canvass | 2018-05-22 | 2207938 | Long Term Care | 4900 N BERNARD ST, CHICAGO, IL, 60625 | Risk 1 (High) | Pass w/ Conditions |
| 2049474 | Canvass Re-Inspection | 2017-04-28 | 2207938 | Long Term Care | 4900 N BERNARD ST, CHICAGO, IL, 60625 | Risk 1 (High) | Pass |
Date of last update: 23 Dec 2024
