OrganizationActive
Beacon Pace Illinois LLC
NPI 1538991104 · PACE Provider Organization · Crestwood, IL
Provider details
- NPI number
- 1538991104
- Entity type
- Organization
- Primary specialty
- PACE Provider OrganizationAgencies
- Organization subpart
- No
- Authorized official
- Michael Czermak, Chief Administrative Officer(855) 801-2653
Specialties & taxonomies
Agencies
Profile Score
Established profile(56/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
5419 135th St
Crestwood, IL 60418-1529
Phone: (855) 801-2653
Street-level locationGet directions
Mailing address
106 W Moore Ave
Mooresville, NC 28115-3551
Other names (DBA / former)
- Doing business as
- Boldage Pace Illinois
Registry dates
- Enumerated
- 2024-08-14
- Last updated
- 2026-01-06
- Certified
- 2026-01-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.