340B Drug Pricing Program Database


CH057440 PCC COMMUNITY WELLNESS CENTER (Active) - information as of 5/19/2025 12:43:13 AM

Main Details
PCC COMMUNITY WELLNESS CENTER
PCC Lake Street Family Health Center
HRSA-Funded Health Center
BPS-H80-001692
CH057440
H80CS00276


Additional Details
Active
7/1/1997
7/1/1997
9/15/2003
2/10/2025

Contacts

PCC Community Wellness Center
Alyssa Sianghio, Chief Executive Officer
(708) 383-1113

PCC Community Wellness Center
Sonia Taylor, Senior Director, Finance
(708) 262-0038

Addresses

14 Lake St
Oak Park, IL 60302-2606

Same as Street Address


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Grantee Sites
  • Grantee Sites Contract Pharmacies
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

No
Shipping Addresses

Same as Street Address
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03779 100 LAKE ST
MAYWOODIL6015305/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04664 10345 W ROOSEVELT ROAD
WESTCHESTERIL6015405/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04147 1546 N. CENTRAL AVE.
CHICAGOIL60651-125905/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05149 1600 W. ROOSEVELT RD
BROADVIEWIL6015505/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 11410 1627 N PULASKI RD
CHICAGOIL6063905/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03749 2200 N. LEWIS AVE.
WAUKEGANIL6008705/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03961 2340 W MADISON ST
CHICAGOIL6061205/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03833 2828 N HARLEM
ELMWOOD PARKIL6070705/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 01310 3110 W ARMITAGE
CHICAGOIL6064705/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05057 3153 W IRVING PARK RD
CHICAGOIL6061805/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03395 3401 W ROOSEVELT RD
CHICAGOIL6062405/07/201205/07/2012 11/12/202411/18/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04936 4040 N. CICERO AVE.
CHICAGOIL6064105/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 01495 4225 W. ARMITAGE
CHICAGOIL6063905/07/201205/07/2012 08/07/201508/07/2015
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04862 4343 N CENTRAL AVE
CHICAGOIL6063405/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04009 4730 BUTTERFIELD ROAD
HILLSIDEIL6016205/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04938 4748 W NORTH AVE
CHICAGOIL6063905/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 02903 5222 WEST MADISON ST
CHICAGOIL6064405/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04008 540 25TH AVENUE
BELLWOODIL6010405/07/201205/07/2012 08/07/201508/07/2015
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04233 5600 W. FULLERTON
CHICAGOIL6063905/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05103 5932 W. CERMAK RD
CICEROIL6080405/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03995 6 E NORTH AVE
NORTHLAKEIL6016405/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05235 6412 ROOSEVELT RD
OAK PARKIL60304-213505/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS #10771 6460 W. FULLERTON AVE
CHICAGOIL6070705/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05076 6800 OGDEN AVE
BERWYNIL6040205/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04935 6809 W BELMONT AVE
CHICAGOIL6063405/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03960 7200 ROOSEVELT RD
FOREST PARKIL6013005/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03076 7251 LAKE STREET
RIVER FORESTIL6030505/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04148 7960 W. 159TH ST.
ORLAND PARKIL6046205/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS #11760 811 MADISON ST
OAK PARKIL6030205/07/201205/07/2012  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 01298 1372 N MILWAUKEE AVE
CHICAGOIL6062204/04/201307/01/2013  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 02877 2440 W NORTH AVE
CHICAGOIL6064704/04/201307/01/2013  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03994 200 E ROOSEVELT
VILLA PARKIL6018107/02/202010/01/2020  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA WALGREENS SPECIALTY PHARMACY #04505 4025 N. SHERIDAN RD.
CHICAGOIL6061307/02/202010/01/2020  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.WALGREENS # 16525 5401 S WENTWORTH AVE
SUITE 5A1 		CHICAGOIL6060907/02/202010/01/2020  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05121 5935 W ADDISON
CHICAGOIL6063407/02/202010/01/2020  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04986 4745 W BELMONT AVE
CHICAGOIL60641-441010/14/202001/01/2021  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 02785 5840 WEST 35TH ST
CICEROIL6080407/06/202210/01/2022  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05034 6315 S KEDZIE AVE
CHICAGOIL6062907/06/202210/01/2022  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04826 9800 IRVING PARK ROAD
SCHILLER PARKIL6017601/10/202304/01/2023  02/26/2024
Contract DetailBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04978 111 S. HALSTED STREET
CHICAGOIL6066101/10/202304/01/2023  02/26/2024
Contract DetailCAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361401/13/202104/01/2021  02/26/2024
Contract DetailCAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005601/13/202104/01/2021  02/26/2024
Contract DetailCAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621901/13/202104/01/2021  02/26/2024
Contract DetailCAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175701/13/202104/01/2021  02/26/2024
Contract DetailCAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808301/13/202104/01/2021  02/26/2024
Contract DetailCAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700401/13/202104/01/2021  02/26/2024
Contract DetailCAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761701/13/202104/01/2021  02/26/2024
Contract DetailCAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813301/15/202104/01/2021  02/26/2024
Contract DetailCAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A 		REDLANDSCA9237401/13/202104/01/2021  02/26/2024
Contract DetailCAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911901/13/202104/01/2021  02/26/2024
Contract DetailCVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870604/02/202107/01/2021  02/26/2024
Contract DetailCVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005604/02/202107/01/2021  02/26/2024
Contract DetailCVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502801/13/202104/01/2021  02/26/2024
Contract DetailGENOA HEALTHCARE LLC1845 GRANDSTAND PL STE 300
ELGINIL6012304/11/202407/01/2024  07/01/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.CVS/PHARMACY # 17686 1346 E 53RD ST
CHICAGOIL6061501/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.CVS/PHARMACY # 17683 2650 N CLARK ST
CHICAGOIL6061401/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17677 401 E ILLINOIS ST
CHICAGOIL6061101/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17643 1 S STATE ST
CHICAGOIL6060301/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17634 1101 W JACKSON BLVD
CHICAGOIL6060701/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17591 1200 N LARRABEE ST
CHICAGOIL6061001/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17536 130 S MANNHEIM RD
HILLSIDEIL6016201/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17437 4466 N BROADWAY ST
CHICAGOIL6064001/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17169 800 BROADVIEW VILLAGE SQ
BROADVIEWIL6015501/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08756 6200 W HIGGINS
CHICAGOIL6063001/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08753 3637 N SOUTHPORT
CHICAGOIL6061301/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08751 4051 N LINCOLN
CHICAGOIL6061801/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17166 1940 W 33RD ST
CHICAGOIL6060801/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17042 6525 W DIVERSEY AVE
CHICAGOIL6070701/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17009 1154 S CLARK ST
CHICAGOIL6060501/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17008 4050 N HARLEM AVE
NORRIDGEIL6070601/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 16999 4433 S PULASKI RD
CHICAGOIL6063201/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 16771 2939 W ADDISON ST
CHICAGOIL6061801/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 16361 2656 N ELSTON AVE
CHICAGOIL6064701/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 16285 7100 S CICERO AVE
CHICAGOIL6062901/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 16281 850 W NORTH AVE
MELROSE PARKIL6016001/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 16219 2901 S CICERO AVE
CICEROIL6080401/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08910 205 N COLUMBUS DR
CHICAGOIL6060101/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08750 4801 N CENTRAL
CHICAGOIL6063001/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08745 771 N OGDEN AVE
CHICAGOIL6064201/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08744 9139 BROADWAY
BROOKFIELDIL6051301/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08742 5524 W CERMAK RD, STE 1
CICEROIL6080401/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08741 2634 S PULASKI
CHICAGOIL6062301/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08740 2427 W CHICAGO AVE
CHICAGOIL6062201/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08739 1819 N. HARLEM AVENUE
CHICAGOIL6070701/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08738 741 W 31ST
CHICAGOIL6061601/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08737 2414 N. LINCOLN AVE.
CHICAGOIL6061401/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08736 7216 CIRCLE AVE
FOREST PARKIL6013001/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08735 3940 WEST FULLERTON
CHICAGOIL6064701/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08731 400 W MADISON ST
CHICAGOIL6060601/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08699 137 S STATE ST
CHICAGOIL6060301/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08698 1165 N. CLARK
CHICAGOIL6061001/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08695 3101 N. CLARK
CHICAGOIL6065701/13/202104/01/2021 02/04/202202/04/2022
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08502 6315 S PULASKI RD STE 1
CHICAGOIL6062901/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 07761 10420 GRAND AVE.
FRANKLIN PARKIL6013101/13/202104/01/2021 09/15/202301/16/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 06785 3343 W. MONTROSE AVE.
CHICAGOIL6061801/13/202104/01/2021 06/15/202301/16/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 05987 4800 NORTH DAMEN
CHICAGOIL6062501/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 05836 1228 E. 53RD ST.
CHICAGOIL6061501/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 05768 130 S. CANAL ST.
CHICAGOIL6060601/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 05482 3615 N. CENTRAL AVE
CHICAGOIL6063401/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA CVS/PHARMACY # 5394 1200 N. ASHLAND, UNIT C-1
CHICAGOIL6062201/13/202104/01/2021 04/05/202304/05/2023
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 05213 8911 OGDEN AVE.
BROOKFIELDIL6051301/13/202104/01/2021 06/20/202301/16/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 05001 3033 N. BROADWAY ST.
CHICAGOIL6065701/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 04979 7855 S. WESTERN AVE.
CHICAGOIL6062001/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 04793 1211 W. ROOSEVELT RD.
CHICAGOIL6060801/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 04781 205 N. MICHIGAN AVE.
CHICAGOIL6060101/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 04061 520 S. STATE STREET
CHICAGOIL6060501/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 03889 7929 NORTH AVE.
RIVER FORESTIL6030501/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 03742 121 W KINZIE ST
CHICAGOIL6065401/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 03170 6417 W. HIGGINS AVE.
CHICAGOIL6065601/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 03163 345 MADISON ST.
OAK PARKIL6030201/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 02981 1201 N. STATE ST.
CHICAGOIL6061001/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 02942 401 W. ARMITAGE AVE.
CHICAGOIL6061401/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 02934 208 W. WASHINGTON ST.
CHICAGOIL6060601/13/202104/01/2021 10/12/202210/12/2022
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 02862 3944 N. WESTERN AVE.
CHICAGOIL6061801/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 02860 110 W. NORTH AVE.
ELMHURSTIL6012601/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 02844 6748 ROOSEVELT RD.
OAK PARKIL6030401/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 02827 600 NORTH MANNHEIM RD.
HILLSIDEIL6016201/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 02809 2815 N. WESTERN AVE.
CHICAGOIL6061801/13/202104/01/2021 02/07/202302/07/2023
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA CVS/PHARMACY # 1965 7200 W. CERMAK RD.
NORTH RIVERSIDEIL6054601/13/202104/01/2021 04/11/202404/11/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 01054 101 N. CLINTON ST.
CHICAGOIL6066101/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 00788 344 WEST HUBBARD
CHICAGOIL6065401/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 05681 3311 N. PULASKI RD.
CHICAGOIL6064101/13/202104/01/2021  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.CVS/PHARMACY # 17717 1129 LAKE ST
OAK PARKIL6030104/04/202207/01/2022  02/26/2024
Contract DetailHIGHLAND PARK CVS, L.L.C.CVS/PHARMACY # 10942 310 SOUTH MICHIGAN AVE
CHICAGOIL6060404/15/202207/01/2022  02/26/2024
Contract DetailMIDWEST PHARMACIES INCDBA PLAZA PHARMACY 1 ERIE CT
OAK PARKIL60302-256601/15/201904/01/2019 04/05/202304/05/2023
Contract DetailMIDWEST PHARMACIES INCDBA WESTLAKE MEDICAL ARTS PHARAMCY 1111 SUPERIOR ST
MELROSE PARKIL60160-413801/15/201904/01/2019 01/01/202001/09/2023
Contract DetailPROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514601/13/202104/01/2021  02/26/2024
Contract DetailPROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523301/13/202104/01/2021  02/26/2024
Contract DetailPROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY OR CARELONRX SPECIALTY ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1 		HONOLULUHI9681301/13/202104/01/2021  02/26/2024
Contract DetailPROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920301/13/202104/01/2021  02/26/2024
Contract DetailSHEFFIELD AVENUE CVS, L.L.C.DBA: CVS/PHARMACY # 03690 1714 N. SHEFFIELD AVE.
CHICAGOIL6061401/13/202104/01/2021  02/26/2024
Contract DetailSOUTH WABASH CVS, L.L.C.DBA: CVS/PHARMACY # 03674 105 S. WABASH AVE.
CHICAGOIL6060301/13/202104/01/2021  02/26/2024
Contract DetailWAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738610/03/201801/01/2019  02/26/2024
Contract DetailWAL-MART PHARMACY 10-22041300 DES PLAINES AVENUE
FOREST PARKIL6013010/03/201801/01/2019  02/26/2024
Contract DetailWAL-MART PHARMACY 10-54024650 WEST NORTH AVE
CHICAGOIL6063910/03/201801/01/2019  02/26/2024
Contract DetailWAL-MART PHARMACY 10-56174626 W DIVERSEY AVE.
CHICAGOIL6063910/03/201801/01/2019  02/26/2024
Contract DetailWAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283710/03/201801/01/2019  02/26/2024
Contract DetailWALGREEN CODBA: WALGREENS #15525 201 E. HURON STREET, SUITE 01-210
CHICAGOIL6061101/12/201704/01/2017  02/26/2024
Contract DetailWalgreen CODBA Walgreens Central Fill #21417 599 S Schmidt Rd
Ste A 		BolingbrookIL60440-940501/09/202304/01/2023  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 09600 1445 W NORTH AVE
MELROSE PARKIL6016005/07/201205/07/2012  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 07559 16 W ADAMS STREET
CHICAGOIL6060305/07/201205/07/2012 10/14/201610/14/2016
Contract DetailWALGREEN CO.DBA: WALGREENS # 13826 7200 W. NORTH AVE.
ELMWOOD PARKIL6070705/07/201205/07/2012  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 09000 2001 N MILWAUKEE AVE
CHICAGOIL60647-400105/07/201205/07/2012  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 01249 4800 W CERMAK RD
CICEROIL6080405/07/201205/07/2012 11/06/202411/18/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 09470 4817 W FULLERTON AVE
CHICAGOIL60639-250305/07/201205/07/2012  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 03948 5140 W DIVERSEY AVE
CHICAGOIL6063905/07/201205/07/2012  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 00118 5650 W BELMONT AVE
CHICAGOIL6063405/07/201205/07/2012 10/15/202110/15/2021
Contract DetailWALGREEN CO.DBA: WALGREENS # 11154 7113 CERMAK RD
BERWYNIL6040205/07/201205/07/2012  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 01449 8000 BROADVIEW VILLAGE SQUARE
BROADVIEWIL60155-260105/07/201205/07/2012  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 00829 8361 BELMONT AVE
RIVER GROVEIL6017105/07/201205/07/2012  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 06462 9595 GRAND AVE
FRANKLIN PARKIL6013105/07/201205/07/2012  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 00252 7510 N WESTERN AVE
CHICAGOIL6064504/04/201307/01/2013  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 03950 4343 N KEDZIE AVE
CHICAGOIL6061804/04/201307/01/2013  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 05868 3798 SOUTH WESTERN AVE
CHICAGOIL60609-101404/04/201307/01/2013 08/07/201508/07/2015
Contract DetailWALGREEN CO.DBA: WALGREENS # 05926 4385 S ARCHER AVE
CHICAGOIL6063204/04/201307/01/2013  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 09709 4010 W LAWRENCE AVE
CHICAGOIL6063004/04/201307/01/2013  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 10649 3424 W BELMONT AVE
CHICAGOIL6061804/04/201307/01/2013  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS #13966 3249 S. OAK PARK AVE STE T1201
BERWYNIL6040210/14/201601/01/2017 10/15/202110/15/2021
Contract DetailWALGREEN CO.WALGREENS SPECIALTY PHARMACY #16498 2351 E 71ST ST
SUITE A 		CHICAGOIL6064910/14/201601/01/2017  02/26/2024
Contract DetailWALGREEN CO.WALGREENS SPECIALTY PHARMACY #15305 912 W BELMONT AVE
CHICAGOIL6065710/14/201601/01/2017  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 07687 3320 W FULLERTON AVE
CHICAGOIL60647-251401/12/201704/01/2017  02/26/2024
Contract DetailWALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #13974 225 E CHICAGO AVE
STE 03110 		CHICAGOIL6061101/12/201704/01/2017  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS #15507 3800 W MADISON STREET SUITE 101
CHICAGOIL6062401/12/201704/01/2017  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 06727 4720 N MARINE DRIVE
CHICAGOIL60640-512010/15/201801/01/2019  02/26/2024
Contract DetailWALGREEN CO.WALGREENS SPECIALTY PHARMACY #13832 4339 DIPAOLO CENTER
GLENVIEWIL6002510/15/201801/01/2019  02/26/2024
Contract DetailWALGREEN CO.DBA WALGREENS #15971 259 E. ERIE STREET
SUITE 250 		CHICAGOIL6061110/15/201801/01/2019  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 01450 4101 1ST AVE
LYONSIL6053407/02/202010/01/2020  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS 16299 331 W. SURF ST.
SUITE 101 		CHICAGOIL60657-716007/02/202010/01/2020  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS #13975 711 W NORTH AVE STE #204
CHICAGOIL6061010/14/202001/01/2021 09/18/202301/16/2024
Contract DetailWALGREEN CO.DBA: WALGREENS #13924 1775 W DEMPSTER ST STE T01116
PARK RIDGEIL6006801/15/202104/01/2021  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 05124 8628 S COTTAGE GROVE AVE
CHICAGOIL6061907/06/202210/01/2022  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 10350 7109 S JEFFERY BLVD
CHICAGOIL60649-242507/06/202210/01/2022  02/26/2024
Contract DetailWALGREEN CO.DBA WALGREENS #16093 3040 S. CICERO AVE.
SUITE A 		CICEROIL6080407/06/202210/01/2022  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS #11332 4101 N HARLEM AVE
NORRIDGEIL6070601/10/202304/01/2023  02/26/2024
Contract DetailWALGREEN CO.DBA: WALGREENS # 05962 4820 N CUMBERLAND AVE
NORRIDGEIL6070601/16/202404/01/2024  04/01/2024
Contract DetailWALGREEN CO.DBA: WALGREENS #15506 3303 W. 26TH STREET
SUITE 101 		CHICAGOIL6062301/16/202404/01/2024  04/01/2024
Contract DetailWALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
TEMPEAZ8528405/07/201205/07/2012 07/08/201507/09/2015
Contract DetailWALGREENS MAIL SERVICE, INC.  8337 S PARK CIRCLE
ORLANDOFL32819-904904/09/201307/01/2013 07/08/201507/09/2015
Contract DetailWALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
TEMPEAZ8528410/14/201601/01/2017 01/10/201801/10/2018
Contract DetailWALGREENS MAIL SERVICE, LLCWALGREENS MAIL SERVICE #03397 8350 S RIVER PARKWAY
TEMPEAZ8528410/12/201701/01/2018  02/26/2024
Contract DetailWALGREENS.COM, INC.DBA: WALGREENS 2225 S. PRICE ROAD
CHANDLERAZ8528610/12/201701/01/2018  02/26/2024
Contract DetailWALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A 		ROGERSAR7275601/10/202304/01/2023  02/26/2024
Contract DetailWalmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616801/16/202404/01/2024  04/01/2024
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH057440ActiveBPS-H80-001692PCC COMMUNITY WELLNESS CENTERPCC Lake Street Family Health Center14 Lake St Oak ParkIL
CH05744AActiveBPS-H80-008889PCC COMMUNITY WELLNESS CENTERPCC Dental and Specialty Care Center5425 W Lake St ChicagoIL
CH05744BActiveBPS-H80-004210PCC COMMUNITY WELLNESS CENTERPCC SALUD FAMILY HEALTH CENTER5359 W Fullerton Ave ChicagoIL
CH05744CActiveBPS-H80-006585PCC COMMUNITY WELLNESS CENTERPCC CLINIC AT THE BOULEVARD 3456 W Franklin Blvd ChicagoIL
CH05744DActiveBPS-H80-009251PCC COMMUNITY WELLNESS CENTERPCC SOUTH FAMILY HEALTH CENTER6201 Roosevelt Rd BerwynIL
CH05744FActiveBPS-H80-000811PCC COMMUNITY WELLNESS CENTERPCC Dr. Tong Health Center1 Erie Ct STE 6040 Oak ParkIL
CH05744GActiveBPS-H80-011987PCC COMMUNITY WELLNESS CENTERPCC Melrose Park Family Health Center1111 Superior St STE 101 Melrose ParkIL
CH05744ITerminatedBPS-H80-012730PCC COMMUNITY WELLNESS CENTERPCC West Town Family Health Center1044 N Mozart St STE 100 ChicagoIL
CH05744JTerminatedBPS-H80-008587PCC COMMUNITY WELLNESS CENTERPCC Walk-In Wellness Center1044 N. Francisco Ave. ChicagoIL
CH05744KActiveBPS-H80-012462PCC COMMUNITY WELLNESS CENTERPCC Walk-In Wellness Center at West Suburban Medical Center3 Erie Ct STE 1300 Oak ParkIL
CH05744LTerminatedBPS-H80-021231PCC COMMUNITY WELLNESS CENTERPCC Community Wellness Center at West Suburban1 Erie Court Oak ParkIL
CH05744MActiveBPS-H80-015567PCC COMMUNITY WELLNESS CENTERPCC Community Wellness Center at Steinmetz3030 N MOBILE AVE CHICAGOIL
CH05744NTerminatedBPS-H80-018944PCC COMMUNITY WELLNESS CENTERPCC Walk-In Wellness Center at West Suburban Medical Center Suite 70401 Erie Court, Suite 7040 Oak ParkIL
CH05744PTerminatedBPS-H80-027142PCC COMMUNITY WELLNESS CENTERPCC Parkside Family Health Center115 North Parkside Avenue FL 1 ChicagoIL
CH05744QTerminatedBPS-H80-028370PCC COMMUNITY WELLNESS CENTERPCC at Healthcare Alternative Systems, Inc.4534 S. Western Ave ChicagoIL
CH05744RTerminatedBPS-H80-031968PCC COMMUNITY WELLNESS CENTERPCC Sports Medicine and Prenatal Wellness Clinic1 Erie Ct Ste 7140 Oak ParkIL
CH05744SActiveBPS-H80-031870PCC COMMUNITY WELLNESS CENTERPCC Community Wellness Center at West Suburban1 Erie Ct Ste 7120 Oak ParkIL
CH05744TActiveBPS-H80-031969PCC COMMUNITY WELLNESS CENTERPCC West Town Family Health Center2434 W Division St ChicagoIL
CH05744UActiveBPS-H80-034152PCC COMMUNITY WELLNESS CENTERPCC Dr. Burdick Family Health Center1 Erie Ct. STE 6160 Oak ParkIL
CH05744VActiveBPS-H80-033469PCC COMMUNITY WELLNESS CENTERPCC Austin Family Health Center5461 W Lake St ChicagoIL
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03779 100 LAKE ST
MAYWOODIL6015305/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04664 10345 W ROOSEVELT ROAD
WESTCHESTERIL6015405/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04147 1546 N. CENTRAL AVE.
CHICAGOIL60651-125905/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05149 1600 W. ROOSEVELT RD
BROADVIEWIL6015505/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 11410 1627 N PULASKI RD
CHICAGOIL6063905/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03749 2200 N. LEWIS AVE.
WAUKEGANIL6008705/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03961 2340 W MADISON ST
CHICAGOIL6061205/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03833 2828 N HARLEM
ELMWOOD PARKIL6070705/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 01310 3110 W ARMITAGE
CHICAGOIL6064705/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05057 3153 W IRVING PARK RD
CHICAGOIL6061805/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03395 3401 W ROOSEVELT RD
CHICAGOIL6062405/07/2012 11/12/2024
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04936 4040 N. CICERO AVE.
CHICAGOIL6064105/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 01495 4225 W. ARMITAGE
CHICAGOIL6063905/07/2012 08/07/2015
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04862 4343 N CENTRAL AVE
CHICAGOIL6063405/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04009 4730 BUTTERFIELD ROAD
HILLSIDEIL6016205/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04938 4748 W NORTH AVE
CHICAGOIL6063905/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 02903 5222 WEST MADISON ST
CHICAGOIL6064405/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04008 540 25TH AVENUE
BELLWOODIL6010405/07/2012 08/07/2015
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04233 5600 W. FULLERTON
CHICAGOIL6063905/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05103 5932 W. CERMAK RD
CICEROIL6080405/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03995 6 E NORTH AVE
NORTHLAKEIL6016405/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05235 6412 ROOSEVELT RD
OAK PARKIL60304-213505/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS #10771 6460 W. FULLERTON AVE
CHICAGOIL6070705/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05076 6800 OGDEN AVE
BERWYNIL6040205/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04935 6809 W BELMONT AVE
CHICAGOIL6063405/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03960 7200 ROOSEVELT RD
FOREST PARKIL6013005/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03076 7251 LAKE STREET
RIVER FORESTIL6030505/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04148 7960 W. 159TH ST.
ORLAND PARKIL6046205/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS #11760 811 MADISON ST
OAK PARKIL6030205/07/2012  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 01298 1372 N MILWAUKEE AVE
CHICAGOIL6062207/01/2013  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 02877 2440 W NORTH AVE
CHICAGOIL6064707/01/2013  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03994 200 E ROOSEVELT
VILLA PARKIL6018110/01/2020  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA WALGREENS SPECIALTY PHARMACY #04505 4025 N. SHERIDAN RD.
CHICAGOIL6061310/01/2020  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.WALGREENS # 16525 5401 S WENTWORTH AVE
SUITE 5A1 		CHICAGOIL6060910/01/2020  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05121 5935 W ADDISON
CHICAGOIL6063410/01/2020  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04986 4745 W BELMONT AVE
CHICAGOIL60641-441001/01/2021  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 02785 5840 WEST 35TH ST
CICEROIL6080410/01/2022  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05034 6315 S KEDZIE AVE
CHICAGOIL6062910/01/2022  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04826 9800 IRVING PARK ROAD
SCHILLER PARKIL6017604/01/2023  
CH057440BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04978 111 S. HALSTED STREET
CHICAGOIL6066104/01/2023  
CH05744ABOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04147 1546 N. CENTRAL AVE.
CHICAGOIL60651-125910/01/2024  
CH05744BBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04938 4748 W NORTH AVE
CHICAGOIL6063910/01/2024  
CH05744DBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03995 6 E NORTH AVE
NORTHLAKEIL6016410/01/2024  
CH05744FBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05235 6412 ROOSEVELT RD
OAK PARKIL60304-213510/01/2024  
CH05744KBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03779 100 LAKE ST
MAYWOODIL6015310/01/2024  
CH05744MBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 02903 5222 WEST MADISON ST
CHICAGOIL6064410/01/2024  
CH05744SBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03960 7200 ROOSEVELT RD
FOREST PARKIL6013010/01/2024  
CH05744TBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04233 5600 W. FULLERTON
CHICAGOIL6063910/01/2024  
CH05744UBOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS #11760 811 MADISON ST
OAK PARKIL6030210/01/2024  
CH05744VBOND DRUG COMPANY OF ILLINOIS, L.L.C.WALGREENS # 16525 5401 S WENTWORTH AVE
SUITE 5A1 		CHICAGOIL6060907/01/2025  
CH057440CAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361404/01/2021  
CH057440CAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005604/01/2021  
CH057440CAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621904/01/2021  
CH057440CAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175704/01/2021  
CH057440CAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808304/01/2021  
CH057440CAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700404/01/2021  
CH057440CAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761704/01/2021  
CH057440CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813304/01/2021  
CH057440CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A 		REDLANDSCA9237404/01/2021  
CH057440CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911904/01/2021  
CH057440CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870607/01/2021  
CH057440CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005607/01/2021  
CH057440CVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502804/01/2021  
CH057440GENOA HEALTHCARE LLC1845 GRANDSTAND PL STE 300
ELGINIL6012307/01/2024  
CH057440HIGHLAND PARK CVS, L.L.C.CVS/PHARMACY # 17686 1346 E 53RD ST
CHICAGOIL6061504/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.CVS/PHARMACY # 17683 2650 N CLARK ST
CHICAGOIL6061404/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17677 401 E ILLINOIS ST
CHICAGOIL6061104/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17643 1 S STATE ST
CHICAGOIL6060304/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17634 1101 W JACKSON BLVD
CHICAGOIL6060704/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17591 1200 N LARRABEE ST
CHICAGOIL6061004/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17536 130 S MANNHEIM RD
HILLSIDEIL6016204/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17437 4466 N BROADWAY ST
CHICAGOIL6064004/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17169 800 BROADVIEW VILLAGE SQ
BROADVIEWIL6015504/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08756 6200 W HIGGINS
CHICAGOIL6063004/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08753 3637 N SOUTHPORT
CHICAGOIL6061304/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08751 4051 N LINCOLN
CHICAGOIL6061804/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17166 1940 W 33RD ST
CHICAGOIL6060804/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17042 6525 W DIVERSEY AVE
CHICAGOIL6070704/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17009 1154 S CLARK ST
CHICAGOIL6060504/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17008 4050 N HARLEM AVE
NORRIDGEIL6070604/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 16999 4433 S PULASKI RD
CHICAGOIL6063204/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 16771 2939 W ADDISON ST
CHICAGOIL6061804/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 16361 2656 N ELSTON AVE
CHICAGOIL6064704/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 16285 7100 S CICERO AVE
CHICAGOIL6062904/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 16281 850 W NORTH AVE
MELROSE PARKIL6016004/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 16219 2901 S CICERO AVE
CICEROIL6080404/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08910 205 N COLUMBUS DR
CHICAGOIL6060104/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08750 4801 N CENTRAL
CHICAGOIL6063004/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08745 771 N OGDEN AVE
CHICAGOIL6064204/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08744 9139 BROADWAY
BROOKFIELDIL6051304/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08742 5524 W CERMAK RD, STE 1
CICEROIL6080404/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08741 2634 S PULASKI
CHICAGOIL6062304/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08740 2427 W CHICAGO AVE
CHICAGOIL6062204/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08739 1819 N. HARLEM AVENUE
CHICAGOIL6070704/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08738 741 W 31ST
CHICAGOIL6061604/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08737 2414 N. LINCOLN AVE.
CHICAGOIL6061404/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08736 7216 CIRCLE AVE
FOREST PARKIL6013004/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08735 3940 WEST FULLERTON
CHICAGOIL6064704/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08731 400 W MADISON ST
CHICAGOIL6060604/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08699 137 S STATE ST
CHICAGOIL6060304/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08698 1165 N. CLARK
CHICAGOIL6061004/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08695 3101 N. CLARK
CHICAGOIL6065704/01/2021 02/04/2022
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08502 6315 S PULASKI RD STE 1
CHICAGOIL6062904/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 07761 10420 GRAND AVE.
FRANKLIN PARKIL6013104/01/2021 09/15/2023
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 06785 3343 W. MONTROSE AVE.
CHICAGOIL6061804/01/2021 06/15/2023
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 05987 4800 NORTH DAMEN
CHICAGOIL6062504/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 05836 1228 E. 53RD ST.
CHICAGOIL6061504/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 05768 130 S. CANAL ST.
CHICAGOIL6060604/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 05482 3615 N. CENTRAL AVE
CHICAGOIL6063404/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA CVS/PHARMACY # 5394 1200 N. ASHLAND, UNIT C-1
CHICAGOIL6062204/01/2021 04/05/2023
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 05213 8911 OGDEN AVE.
BROOKFIELDIL6051304/01/2021 06/20/2023
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 05001 3033 N. BROADWAY ST.
CHICAGOIL6065704/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 04979 7855 S. WESTERN AVE.
CHICAGOIL6062004/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 04793 1211 W. ROOSEVELT RD.
CHICAGOIL6060804/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 04781 205 N. MICHIGAN AVE.
CHICAGOIL6060104/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 04061 520 S. STATE STREET
CHICAGOIL6060504/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 03889 7929 NORTH AVE.
RIVER FORESTIL6030504/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 03742 121 W KINZIE ST
CHICAGOIL6065404/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 03170 6417 W. HIGGINS AVE.
CHICAGOIL6065604/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 03163 345 MADISON ST.
OAK PARKIL6030204/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 02981 1201 N. STATE ST.
CHICAGOIL6061004/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 02942 401 W. ARMITAGE AVE.
CHICAGOIL6061404/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 02934 208 W. WASHINGTON ST.
CHICAGOIL6060604/01/2021 10/12/2022
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 02862 3944 N. WESTERN AVE.
CHICAGOIL6061804/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 02860 110 W. NORTH AVE.
ELMHURSTIL6012604/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 02844 6748 ROOSEVELT RD.
OAK PARKIL6030404/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 02827 600 NORTH MANNHEIM RD.
HILLSIDEIL6016204/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 02809 2815 N. WESTERN AVE.
CHICAGOIL6061804/01/2021 02/07/2023
CH057440HIGHLAND PARK CVS, L.L.C.DBA CVS/PHARMACY # 1965 7200 W. CERMAK RD.
NORTH RIVERSIDEIL6054604/01/2021 04/11/2024
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 01054 101 N. CLINTON ST.
CHICAGOIL6066104/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 00788 344 WEST HUBBARD
CHICAGOIL6065404/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 05681 3311 N. PULASKI RD.
CHICAGOIL6064104/01/2021  
CH057440HIGHLAND PARK CVS, L.L.C.CVS/PHARMACY # 17717 1129 LAKE ST
OAK PARKIL6030107/01/2022  
CH057440HIGHLAND PARK CVS, L.L.C.CVS/PHARMACY # 10942 310 SOUTH MICHIGAN AVE
CHICAGOIL6060407/01/2022  
CH057440MIDWEST PHARMACIES INCDBA PLAZA PHARMACY 1 ERIE CT
OAK PARKIL60302-256604/01/2019 04/05/2023
CH057440MIDWEST PHARMACIES INCDBA WESTLAKE MEDICAL ARTS PHARAMCY 1111 SUPERIOR ST
MELROSE PARKIL60160-413804/01/2019 01/01/2020
CH057440PROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514604/01/2021  
CH057440PROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523304/01/2021  
CH057440PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY OR CARELONRX SPECIALTY ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1 		HONOLULUHI9681304/01/2021  
CH057440PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920304/01/2021  
CH057440SHEFFIELD AVENUE CVS, L.L.C.DBA: CVS/PHARMACY # 03690 1714 N. SHEFFIELD AVE.
CHICAGOIL6061404/01/2021  
CH057440SOUTH WABASH CVS, L.L.C.DBA: CVS/PHARMACY # 03674 105 S. WABASH AVE.
CHICAGOIL6060304/01/2021  
CH057440WAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738601/01/2019  
CH057440WAL-MART PHARMACY 10-22041300 DES PLAINES AVENUE
FOREST PARKIL6013001/01/2019  
CH057440WAL-MART PHARMACY 10-54024650 WEST NORTH AVE
CHICAGOIL6063901/01/2019  
CH057440WAL-MART PHARMACY 10-56174626 W DIVERSEY AVE.
CHICAGOIL6063901/01/2019  
CH057440WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283701/01/2019  
CH057440WALGREEN CODBA: WALGREENS #15525 201 E. HURON STREET, SUITE 01-210
CHICAGOIL6061104/01/2017  
CH057440Walgreen CODBA Walgreens Central Fill #21417 599 S Schmidt Rd
Ste A 		BolingbrookIL60440-940504/01/2023  
CH057440WALGREEN CO.DBA: WALGREENS # 09600 1445 W NORTH AVE
MELROSE PARKIL6016005/07/2012  
CH057440WALGREEN CO.DBA: WALGREENS # 07559 16 W ADAMS STREET
CHICAGOIL6060305/07/2012 10/14/2016
CH057440WALGREEN CO.DBA: WALGREENS # 13826 7200 W. NORTH AVE.
ELMWOOD PARKIL6070705/07/2012  
CH057440WALGREEN CO.DBA: WALGREENS # 09000 2001 N MILWAUKEE AVE
CHICAGOIL60647-400105/07/2012  
CH057440WALGREEN CO.DBA: WALGREENS # 01249 4800 W CERMAK RD
CICEROIL6080405/07/2012 11/06/2024
CH057440WALGREEN CO.DBA: WALGREENS # 09470 4817 W FULLERTON AVE
CHICAGOIL60639-250305/07/2012  
CH057440WALGREEN CO.DBA: WALGREENS # 03948 5140 W DIVERSEY AVE
CHICAGOIL6063905/07/2012  
CH057440WALGREEN CO.DBA: WALGREENS # 00118 5650 W BELMONT AVE
CHICAGOIL6063405/07/2012 10/15/2021
CH057440WALGREEN CO.DBA: WALGREENS # 11154 7113 CERMAK RD
BERWYNIL6040205/07/2012  
CH057440WALGREEN CO.DBA: WALGREENS # 01449 8000 BROADVIEW VILLAGE SQUARE
BROADVIEWIL60155-260105/07/2012  
CH057440WALGREEN CO.DBA: WALGREENS # 00829 8361 BELMONT AVE
RIVER GROVEIL6017105/07/2012  
CH057440WALGREEN CO.DBA: WALGREENS # 06462 9595 GRAND AVE
FRANKLIN PARKIL6013105/07/2012  
CH057440WALGREEN CO.DBA: WALGREENS # 00252 7510 N WESTERN AVE
CHICAGOIL6064507/01/2013  
CH057440WALGREEN CO.DBA: WALGREENS # 03950 4343 N KEDZIE AVE
CHICAGOIL6061807/01/2013  
CH057440WALGREEN CO.DBA: WALGREENS # 05868 3798 SOUTH WESTERN AVE
CHICAGOIL60609-101407/01/2013 08/07/2015
CH057440WALGREEN CO.DBA: WALGREENS # 05926 4385 S ARCHER AVE
CHICAGOIL6063207/01/2013  
CH057440WALGREEN CO.DBA: WALGREENS # 09709 4010 W LAWRENCE AVE
CHICAGOIL6063007/01/2013  
CH057440WALGREEN CO.DBA: WALGREENS # 10649 3424 W BELMONT AVE
CHICAGOIL6061807/01/2013  
CH057440WALGREEN CO.DBA: WALGREENS #13966 3249 S. OAK PARK AVE STE T1201
BERWYNIL6040201/01/2017 10/15/2021
CH057440WALGREEN CO.WALGREENS SPECIALTY PHARMACY #16498 2351 E 71ST ST
SUITE A 		CHICAGOIL6064901/01/2017  
CH057440WALGREEN CO.WALGREENS SPECIALTY PHARMACY #15305 912 W BELMONT AVE
CHICAGOIL6065701/01/2017  
CH057440WALGREEN CO.DBA: WALGREENS # 07687 3320 W FULLERTON AVE
CHICAGOIL60647-251404/01/2017  
CH057440WALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #13974 225 E CHICAGO AVE
STE 03110 		CHICAGOIL6061104/01/2017  
CH057440WALGREEN CO.DBA: WALGREENS #15507 3800 W MADISON STREET SUITE 101
CHICAGOIL6062404/01/2017  
CH057440WALGREEN CO.DBA: WALGREENS # 06727 4720 N MARINE DRIVE
CHICAGOIL60640-512001/01/2019  
CH057440WALGREEN CO.WALGREENS SPECIALTY PHARMACY #13832 4339 DIPAOLO CENTER
GLENVIEWIL6002501/01/2019  
CH057440WALGREEN CO.DBA WALGREENS #15971 259 E. ERIE STREET
SUITE 250 		CHICAGOIL6061101/01/2019  
CH057440WALGREEN CO.DBA: WALGREENS # 01450 4101 1ST AVE
LYONSIL6053410/01/2020  
CH057440WALGREEN CO.DBA: WALGREENS 16299 331 W. SURF ST.
SUITE 101 		CHICAGOIL60657-716010/01/2020  
CH057440WALGREEN CO.DBA: WALGREENS #13975 711 W NORTH AVE STE #204
CHICAGOIL6061001/01/2021 09/18/2023
CH057440WALGREEN CO.DBA: WALGREENS #13924 1775 W DEMPSTER ST STE T01116
PARK RIDGEIL6006804/01/2021  
CH057440WALGREEN CO.DBA: WALGREENS # 05124 8628 S COTTAGE GROVE AVE
CHICAGOIL6061910/01/2022  
CH057440WALGREEN CO.DBA: WALGREENS # 10350 7109 S JEFFERY BLVD
CHICAGOIL60649-242510/01/2022  
CH057440WALGREEN CO.DBA WALGREENS #16093 3040 S. CICERO AVE.
SUITE A 		CICEROIL6080410/01/2022  
CH057440WALGREEN CO.DBA: WALGREENS #11332 4101 N HARLEM AVE
NORRIDGEIL6070604/01/2023  
CH057440WALGREEN CO.DBA: WALGREENS # 05962 4820 N CUMBERLAND AVE
NORRIDGEIL6070604/01/2024  
CH057440WALGREEN CO.DBA: WALGREENS #15506 3303 W. 26TH STREET
SUITE 101 		CHICAGOIL6062304/01/2024  
CH05744CWALGREEN CO.DBA: WALGREENS # 09470 4817 W FULLERTON AVE
CHICAGOIL60639-250310/01/2024  
CH05744GWALGREEN CO.DBA: WALGREENS # 09600 1445 W NORTH AVE
MELROSE PARKIL6016010/01/2024  
CH057440WALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
TEMPEAZ8528405/07/2012 07/08/2015
CH057440WALGREENS MAIL SERVICE, INC.  8337 S PARK CIRCLE
ORLANDOFL32819-904907/01/2013 07/08/2015
CH057440WALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
TEMPEAZ8528401/01/2017 01/10/2018
CH057440WALGREENS MAIL SERVICE, LLCWALGREENS MAIL SERVICE #03397 8350 S RIVER PARKWAY
TEMPEAZ8528401/01/2018  
CH057440WALGREENS.COM, INC.DBA: WALGREENS 2225 S. PRICE ROAD
CHANDLERAZ8528601/01/2018  
CH057440WALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A 		ROGERSAR7275604/01/2023  
CH057440Walmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616804/01/2024  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification1/31/2024 5:41:08 PM2/10/2025 10:54:32 AM2/10/2025 10:54 AM
DetailsEntity SubnameUpdateChange RequestPCC COMMUNITY WELLNESS CENTERPCC Lake Street Family Health Center1/15/2025 8:16 AM
ContactsAuthorizing OfficialUpdateGroup Change RequestUrso, Robert President & CEO PCC Community Wellness Center 7085247686Sianghio, Alyssa Chief Executive Officer PCC Community Wellness Center 70838311137/12/2024 8:05 AM
DatesLast Date That 340B Drugs PurchasedUpdateOPA Cancel Termination Request1/23/2024 12:00:00 AM 2/26/2024 7:40 AM
DetailsStateUpdateOPA Cancel Termination RequestTo Be TerminatedActive2/26/2024 7:40 AM
TerminationsTermination DateUpdateOPA Cancel Termination Request4/1/2024 12:00:00 AM 2/26/2024 7:40 AM
TerminationsTermination Effective DateUpdateOPA Cancel Termination Request1/23/2024 12:00:00 AM 2/26/2024 7:40 AM
TerminationsTermination ReasonUpdateOPA Cancel Termination RequestBusiness decision by the Covered Entity 2/26/2024 7:40 AM
DatesLast Date That 340B Drugs PurchasedUpdateTermination Request 1/23/2024 12:00:00 AM2/22/2024 5:46 PM
DetailsStateUpdateTermination RequestActiveTo Be Terminated2/22/2024 5:46 PM
TerminationsTermination DateUpdateTermination Request 4/1/2024 12:00:00 AM2/22/2024 5:46 PM
TerminationsTermination Effective DateUpdateTermination Request 1/23/2024 12:00:00 AM2/22/2024 5:46 PM
TerminationsTermination ReasonUpdateTermination Request Business decision by the Covered Entity2/22/2024 5:46 PM
DetailsLast Recertification DateUpdateRecertification2/7/2023 10:51:02 AM1/31/2024 5:41:08 PM1/31/2024 5:41 PM
ContactsPrimary ContactUpdateChange RequestGarrick, Patrick R Chief Financial Officer PCC Community Wellness Center 7083830113-7340Taylor, Sonia Senior Director, Finance PCC Community Wellness Center 70826200381/16/2024 3:21 PM
ContactsAuthorizing OfficialUpdateAO Change RequestBush, Toni President and CEO PCC Community Wellness Center 7085247678Urso, Robert President & CEO PCC Community Wellness Center 70852476861/16/2024 1:52 PM
DetailsLast Recertification DateUpdateRecertification2/4/2022 11:09:55 AM2/7/2023 10:51:02 AM2/7/2023 10:51 AM
DetailsLast Recertification DateUpdateRecertification2/3/2021 10:42:40 AM2/4/2022 11:09:55 AM2/4/2022 11:09 AM
ContactsAuthorizing OfficialUpdateAO Change RequestUrso, Robert President & CEO PCC Community Wellness Center 7085247686Bush, Toni President and CEO PCC Community Wellness Center 708524767810/13/2021 8:17 AM
DetailsLast Recertification DateUpdateRecertification2/5/2020 5:56:54 PM2/3/2021 10:42:40 AM2/3/2021 10:42 AM
DetailsLast Recertification DateUpdateRecertification2/7/2019 12:50:10 PM2/5/2020 5:56:54 PM2/5/2020 5:56 PM
ContactsPrimary ContactUpdateChange RequestHopkins, Lynn Chief Operating Officer PCC Community Wellness Center 7085247678Garrick, Patrick R Chief Financial Officer PCC Community Wellness Center 7083830113-73409/4/2019 12:09 PM
DetailsLast Recertification DateUpdateRecertification2/8/2018 2:35:31 PM2/7/2019 12:50:10 PM2/7/2019 12:50 PM
DetailsLast Recertification DateUpdateRecertification1/27/2017 12:00:00 AM2/8/2018 2:35:31 PM2/8/2018 2:35 PM
ContactsPrimary ContactUpdate Hopkins, Lynn Chief Operating Officer 7085247678Hopkins, Lynn Chief Operating Officer PCC Community Wellness Center 708524767810/12/2017 1:36 PM
ContactsAuthorizing OfficialUpdate Urso, Robert President & CEO 7085247686Urso, Robert President & CEO PCC Community Wellness Center 708524768610/3/2017 5:34 PM
ContactsPrimary ContactInsert  Hopkins, Lynn Chief Operating Officer 70852476783/16/2017 10:49 AM
ContactsAuthorizing OfficialInsert  Urso, Robert President & CEO 70852476863/16/2017 10:49 AM
AddressesMain AddressInsert   14 Lake St Oak Park, IL 60302-26061/27/2017 2:47 PM
DetailsLast Recertification DateUpdate 2/15/2016 12:00:00 AM1/27/2017 12:00:00 AM1/27/2017 2:47 PM
DetailsLast Recertification DateUpdate 1/28/2015 12:00:00 AM2/15/2016 12:00:00 AM2/15/2016 12:27 PM
DetailsLast Recertification DateUpdate 2/10/2014 12:00:00 AM1/28/2015 12:00:00 AM1/28/2015 12:39 PM
DetailsEntity SubnameUpdate  PCC COMMUNITY WELLNESS CENTER3/31/2014 4:25 PM
DetailsLast Recertification DateUpdate 4/1/2013 12:00:00 AM2/10/2014 12:00:00 AM2/10/2014 1:29 PM
DetailsLast Recertification DateUpdate  4/1/2013 12:00:00 AM3/18/2013 11:22 AM
DetailsLast Recertification DateInsert   6/6/2008 8:56 AM
DetailsGrant NumberInsert  H80CS002766/6/2008 8:56 AM
Details340B IDInsert  CH0574406/6/2008 8:56 AM
DetailsIs Authorizing Official EHB DataInsert   6/6/2008 8:56 AM
DatesLast Date That 340B Drugs PurchasedInsert   6/6/2008 8:56 AM
DetailsMedicare Provider NumberInsert   6/6/2008 8:56 AM
DetailsEntity NameInsert  PCC COMMUNITY WELLNESS CENTER6/6/2008 8:56 AM
DetailsProgram CodeInsert  CH6/6/2008 8:56 AM
DetailsEntity SubnameInsert   6/6/2008 8:56 AM
DatesParticipating Approval DateInsert  9/15/2003 12:00:00 AM6/6/2008 8:56 AM
DetailsStateInsert  Active6/6/2008 8:56 AM
DatesRegistration DateInsert  7/1/1997 12:00:00 AM6/6/2008 8:56 AM
DatesSigned By DateInsert   6/6/2008 8:56 AM
DatesStart DateInsert  7/1/1997 12:00:00 AM6/6/2008 8:56 AM
TerminationsTermination CommentsInsert   6/6/2008 8:56 AM
TerminationsTermination DateInsert   6/6/2008 8:56 AM
TerminationsTermination Effective DateInsert   6/6/2008 8:56 AM
TerminationsTermination ReasonInsert   6/6/2008 8:56 AM