Public record

CMS Hospice All Owners

Associate id: 9032639356 · 15 matching records

Enrollment id
O20250217003309
Associate id
9032639356
Organization name
DOVER HOSPICE IL CHICAGO METRO, LLC
Associate id - owner
0547604258
Type - owner
O
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2024-06-06
Organization name - owner
DOVER HOSPICE, LLC
Address line 1 - owner
300 HUNTER AVE
Address line 2 - owner
STE 200
City - owner
SAINT LOUIS
State - owner
MO
Zip code - owner
631242094
Percentage ownership
100
Created for acquisition - owner
N
Corporation - owner
Y
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Owned by another org or ind - owner
Y
Enrollment id
O20250217003309
Associate id
9032639356
Organization name
DOVER HOSPICE IL CHICAGO METRO, LLC
Associate id - owner
0840632261
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2024-06-06
Organization name - owner
DOVER HOLDINGS, LLC - DOVER HEALTH
Address line 1 - owner
300 HUNTER AVE
Address line 2 - owner
STE 200
City - owner
SAINT LOUIS
State - owner
MO
Zip code - owner
631242094
Percentage ownership
21.6
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
Y
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Owned by another org or ind - owner
Y
Enrollment id
O20250217003309
Associate id
9032639356
Organization name
DOVER HOSPICE IL CHICAGO METRO, LLC
Associate id - owner
0941338685
Type - owner
I
Role code - owner
25
Role text - owner
CONTRACTED MANAGING EMPLOYEE
Association date - owner
2025-05-07
First name - owner
KARIM
Middle name - owner
K
Last name - owner
TOURK
Title - owner
MD;
Enrollment id
O20250217003309
Associate id
9032639356
Organization name
DOVER HOSPICE IL CHICAGO METRO, LLC
Associate id - owner
1456787738
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2024-06-06
First name - owner
STEVEN
Last name - owner
BURGHART
Title - owner
PRESIDENT
Percentage ownership
10
Enrollment id
O20250217003309
Associate id
9032639356
Organization name
DOVER HOSPICE IL CHICAGO METRO, LLC
Associate id - owner
1456787738
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2024-06-06
First name - owner
STEVEN
Last name - owner
BURGHART
Title - owner
PRESIDENT
Percentage ownership
100
Enrollment id
O20250217003309
Associate id
9032639356
Organization name
DOVER HOSPICE IL CHICAGO METRO, LLC
Associate id - owner
1557852589
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2024-06-06
Organization name - owner
THE JENNINGS FAMILY CHILDREN'S TRUST DATED SEPTEMBER 27, 2021
Address line 1 - owner
300 HUNTER AVE
Address line 2 - owner
STE 200
City - owner
SAINT LOUIS
State - owner
MO
Zip code - owner
631242094
Percentage ownership
22
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
Y
Other type text - owner
TRUST
Owned by another org or ind - owner
Y
Enrollment id
O20250217003309
Associate id
9032639356
Organization name
DOVER HOSPICE IL CHICAGO METRO, LLC
Associate id - owner
1759723174
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2024-06-06
Organization name - owner
DOVER HEALTH HOLDINGS, LLC
Address line 1 - owner
300 HUNTER AVE
Address line 2 - owner
STE 200
City - owner
SAINT LOUIS
State - owner
MO
Zip code - owner
631242094
Percentage ownership
98
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
Y
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
Y
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Owned by another org or ind - owner
Y
Enrollment id
O20250217003309
Associate id
9032639356
Organization name
DOVER HOSPICE IL CHICAGO METRO, LLC
Associate id - owner
1951741818
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2024-06-06
First name - owner
STEPHEN
Last name - owner
WERTMAN
Percentage ownership
7.4
Enrollment id
O20250217003309
Associate id
9032639356
Organization name
DOVER HOSPICE IL CHICAGO METRO, LLC
Associate id - owner
2961998919
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2025-05-19
First name - owner
MARY ANN
Last name - owner
BERG
Title - owner
AD;
Enrollment id
O20250217003309
Associate id
9032639356
Organization name
DOVER HOSPICE IL CHICAGO METRO, LLC
Associate id - owner
5496246506
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2024-10-01
Organization name - owner
DOVER CAPITAL MANAGEMENT
Address line 1 - owner
300 HUNTER AVE
Address line 2 - owner
STE 200
City - owner
SAINT LOUIS
State - owner
MO
Zip code - owner
631242094
Percentage ownership
49
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
Y
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Owned by another org or ind - owner
Y
Enrollment id
O20250217003309
Associate id
9032639356
Organization name
DOVER HOSPICE IL CHICAGO METRO, LLC
Associate id - owner
7012267602
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2024-06-06
First name - owner
JOSHUA
Last name - owner
JENNINGS
Percentage ownership
70.6
Enrollment id
O20250217003309
Associate id
9032639356
Organization name
DOVER HOSPICE IL CHICAGO METRO, LLC
Associate id - owner
7012267602
Type - owner
I
Role code - owner
44
Role text - owner
OTHER
Association date - owner
2024-06-06
First name - owner
JOSHUA
Last name - owner
JENNINGS
Enrollment id
O20250217003309
Associate id
9032639356
Organization name
DOVER HOSPICE IL CHICAGO METRO, LLC
Associate id - owner
7012408040
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2024-06-06
Organization name - owner
JRJ REVOCABLE TRUST DATED JANUARY 11, 2017
Address line 1 - owner
300 HUNTER AVE
Address line 2 - owner
STE 200
City - owner
SAINT LOUIS
State - owner
MO
Zip code - owner
631242094
Percentage ownership
49
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
Y
Other type text - owner
TRUST
Owned by another org or ind - owner
Y
Enrollment id
O20250217003309
Associate id
9032639356
Organization name
DOVER HOSPICE IL CHICAGO METRO, LLC
Associate id - owner
7517458557
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2025-05-19
First name - owner
FRED
Last name - owner
GROSSMAN
Title - owner
CHIEF FINANCIAL OFFICER
Enrollment id
O20250217003309
Associate id
9032639356
Organization name
DOVER HOSPICE IL CHICAGO METRO, LLC
Associate id - owner
9133569098
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2024-06-06
First name - owner
ALMIR
Last name - owner
SAJTOVIC
Percentage ownership
7.4

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