340B Drug Pricing Program Database


DSH140119F RUSH UNIVERSITY MEDICAL CENTER (Active) - information as of 4/25/2025 9:21:25 PM

Main Details
RUSH UNIVERSITY MEDICAL CENTER
Neurology Clinic
Disproportionate Share Hospital
Yes
DSH140119F
140119


Additional Details
Active
6/27/2012
10/1/2012
8/17/2012
9/6/2024

Contacts

Rush University Medical Center
Patricia Steeves ONeil, CFO
(312) 942-5647

Health Delivery Management, L.L.C.
Matthew Kemper, Director, Clinical Operations
(312) 563-2326

Addresses

1520 West Harrison Street
7th Floor
Chicago, IL 60607

Rush University Medical Center
1653 W Congress Pkwy
Chicago, IL 60612


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Parent/Child
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
IL362174823017,362174823005,3621748230201326140583,1801908728,1851495899,1932213600
IN 1932213600
WI 1932213600
MI 1932213600
MN 1932213600
OH 1932213600
FL 1932213600
IA 1932213600
AR 1932213600
TN 1932213600
Shipping Addresses

Professional Office Building Pharmacy
1725 West Harrison Street
Suite 418
Chicago, IL 60612

Health Delivery Management, L.L.C.
DBA Rush Cancer Center Pharmacy
1520 W Harrison St Rm 09115
Chicago, IL 60607

Health Delivery Management, L.L.C.
DBA Rush Pharmacy
1520 W Harrison St Rm 04071
Chicago, IL 60607

Health Delivery Management LLC
Rush Specialty Pharmacy
1520 W Harrison St Rm 04068
Chicago, IL 60607

Home Infusion Solutions Pharmacy
610 S Maple Ave Ste 1200
Oak Park, IL 60304
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
DSH140119AAChildDSHRUSH UNIVERSITY MEDICAL CENTERRheumatology IM X Ray Clinic1611 West Harrison StreetChicagoILActive
DSH140119ABChildDSHRUSH UNIVERSITY MEDICAL CENTERNeurology Stroke Clinic1520 West Harrison StreetChicagoILActive
DSH140119ACChildDSHRUSH UNIVERSITY MEDICAL CENTERThoracic Surgery Clinic1520 W Harrison StChicagoILActive
DSH140119ADChildDSHRUSH UNIVERSITY MEDICAL CENTEROtolaryngology Head and Neck Surgery Clinic1611 West Harrison StreetChicagoILActive
DSH140119AEChildDSHRUSH UNIVERSITY MEDICAL CENTERHematology Oncology Infusion Center2455 Corporate West DrLisleILActive
DSH140119AFChildDSHRUSH UNIVERSITY MEDICAL CENTERRush Univ Urology1725 W Harrison StChicagoILActive
DSH140119AGChildDSHRUSH UNIVERSITY MEDICAL CENTERRush Univ Urology LF900 N Westmoreland RdLake ForestILTerminated
DSH140119AHChildDSHRUSH UNIVERSITY MEDICAL CENTERRush Univ Urology Oak Park610 S Maple AveOak ParkILActive
DSH140119AJChildDSHRUSH UNIVERSITY MEDICAL CENTERGeneral Surgery1725 West Harrison StreetCHICAGOILActive
DSH140119AKChildDSHRUSH UNIVERSITY MEDICAL CENTERGeneral Surgery - Colorectal1725 West Harrison StreetCHICAGOILActive
DSH140119ALChildDSHRUSH UNIVERSITY MEDICAL CENTERTransplant1725 West Harrison StreetCHICAGOILActive
DSH140119AMChildDSHRUSH UNIVERSITY MEDICAL CENTERUniversity Infectious Diseases600 South PaulinaCHICAGOILActive
DSH140119ANChildDSHRUSH UNIVERSITY MEDICAL CENTERUniversity Hepatologists1725 West Harrison StreetCHICAGOILActive
DSH140119APChildDSHRUSH UNIVERSITY MEDICAL CENTERPediatric Cardiology - Pediatric Cardiology1620 West Harrison StreetChicagoILActive
DSH140119AQChildDSHRUSH UNIVERSITY MEDICAL CENTERPsychiatry Adult West Campus - Psychiatry Adult West Campus2150 West Harrison StreetChicagoILActive
DSH140119ARChildDSHRUSH UNIVERSITY MEDICAL CENTERPediatric Oncology/Infusion Center - Pediatric Oncology/Infusion Center1725 West Harrison StreetChicagoILActive
DSH140119ASChildDSHRUSH UNIVERSITY MEDICAL CENTERPsychiatry Child West Campus - Psychiatry Child West Campus2150 West Harrison StreetChicagoILActive
DSH140119ATChildDSHRUSH UNIVERSITY MEDICAL CENTERPulmonary Critical Care Medicine - Pulmonary1725 W Harrison StChicagoILTerminated
DSH140119AUChildDSHRUSH UNIVERSITY MEDICAL CENTERNeuromuscular - Neuromuscular1520 W Harrison StChicagoILActive
DSH140119AVChildDSHRUSH UNIVERSITY MEDICAL CENTERIM Pulmonary - IM Pulmonary1520 W Harrison StChicagoILActive
DSH140119AWChildDSHRUSH UNIVERSITY MEDICAL CENTERSurgical Oncology - Surgical Oncology1520 W Harrison StChicagoILActive
DSH140119AXChildDSHRUSH UNIVERSITY MEDICAL CENTERPULMONARY FUNCTION LABORATORY - PULMONARY FUNCTION LABORATORY1520 W Harrison StChicagoILActive
DSH140119AYChildDSHRUSH UNIVERSITY MEDICAL CENTERCARDIOLOGY EP CLINIC - CARDIOLOGY EP CLINIC1725 W Harrison St, Suite 358ChicagoILActive
DSH140119AZChildDSHRUSH UNIVERSITY MEDICAL CENTERGender Affirm Surgery - Clinic - Gender Affirm Surgery - Clinic1725 W Harrison St, Suite 758ChicagoILActive
DSH140119BAChildDSHRUSH UNIVERSITY MEDICAL CENTERInterventional Outpatient Endoscopy - Interventional Outpatient Endoscopy1520 West Harrison StreetChicagoILActive
DSH140119BBChildDSHRUSH UNIVERSITY MEDICAL CENTERInterventional GI - Interventional GI1520 West Harrison StreetChicagoILActive
DSH140119BCChildDSHRUSH UNIVERSITY MEDICAL CENTERUrology Cancer - Urology Cancer1520 West Harrison StreetChicagoILActive
DSH140119BDChildDSHRUSH UNIVERSITY MEDICAL CENTERDiag Services - EEG - Diag Services - EEG1725 West Harrison StreetChicagoILActive
DSH140119BEChildDSHRUSH UNIVERSITY MEDICAL CENTERDiag Srvcs-Echocardiography - Diag Srvcs-Echocardiography1725 West Harrison StreetChicagoILActive
DSH140119BFChildDSHRUSH UNIVERSITY MEDICAL CENTERDiag Srvcs-EKG - Diag Srvcs-EKG1725 West Harrison StreetChicagoILActive
DSH140119BGChildDSHRUSH UNIVERSITY MEDICAL CENTERGeneral Surgery Wound - Clinic - General Surgery Wound - Clinic1725 West Harrison StreetChicagoILActive
DSH140119BHChildDSHRUSH UNIVERSITY MEDICAL CENTERNeuromuscular - Clinic - Neuromuscular - Clinic1725 West Harrison StreetChicagoILActive
DSH140119BJChildDSHRUSH UNIVERSITY MEDICAL CENTERNeurosurgery - Clinic - Neurosurgery - Clinic1520 West Harrison StreetChicagoILActive
DSH140119BKChildDSHRUSH UNIVERSITY MEDICAL CENTERPulmonary Function Laboratory - Pulmonary Function Laboratory1725 West Harrison StreetChicagoILActive
DSH140119BLChildDSHRUSH UNIVERSITY MEDICAL CENTERPulmonary Function Testing - Pulmonary Function Testing1725 West Harrison StreetChicagoILActive
DSH140119BMChildDSHRUSH UNIVERSITY MEDICAL CENTERRUMC BARIATRIC SURGERY - Bariatric Surgery1725 W HARRISON STCHICAGOILActive
DSH140119BNChildDSHRUSH UNIVERSITY MEDICAL CENTERRUMC OPHTHALMOLOGY - Ophthalmology1725 W HARRISON STCHICAGOILActive
DSH140119BPChildDSHRUSH UNIVERSITY MEDICAL CENTERRUMC PLASTIC RECONSTRUCTIVE SURGERY - Plastic Surgery - Ortho Clinic1725 W HARRISON STCHICAGOILActive
DSH140119BQChildDSHRUSH UNIVERSITY MEDICAL CENTERDiag Svcs-Mam Oak Brook-Clinic - Diag Svcs-Mam Oak Brook-Clinic2011 York RdOak BrookILActive
DSH140119BRChildDSHRUSH UNIVERSITY MEDICAL CENTERDiag Svcs Oak Brook - Clinic - Diag Svcs Oak Brook - Clinic2011 York RdOak BrookILActive
DSH140119BSChildDSHRUSH UNIVERSITY MEDICAL CENTERRUMG Audiology ROPH - Audiology610 S Maple Ave, Ste 3700Oak ParkILActive
DSH140119BTChildDSHRUSH UNIVERSITY MEDICAL CENTERRUMC AUDIOLOGY - Audiology1611 W HARRISON STCHICAGOILActive
DSH140119BUChildDSHRUSH UNIVERSITY MEDICAL CENTERUrogynecology - OB GYN Urogyn - Clinic1725 West Harrison StreetChicagoILActive
DSH140119BVChildDSHRUSH UNIVERSITY MEDICAL CENTERRUMG Physical Med & Rehab - Physical Med & Rehab - Clinic1520 West Harrison StreetChicagoILActive
DSH140119BWChildDSHRUSH UNIVERSITY MEDICAL CENTEROB Maternal Fetal Medicine - Maternal Fetal Medicine1725 West Harrison StreetChicagoILActive
DSH140119BXChildDSHRUSH UNIVERSITY MEDICAL CENTERIM Gastroenterology Infusion - IM Gastroenterology Infusion1520 W Harrison StChicagoILActive
DSH140119BYChildDSHRUSH UNIVERSITY MEDICAL CENTERMohs Surgery - Clinic - Mohs Surgery - Clinic1725 West Harrison StreetChicagoILActive
DSH140119BZChildDSHRUSH UNIVERSITY MEDICAL CENTERPlastic Surgery - Clinic RAB - Plastic Surgery - Clinic RAB1520 W Harrison StChicagoILActive
DSH140119CAChildDSHRUSH UNIVERSITY MEDICAL CENTERRUMC OB GYNE - OB GYN - Clinic1725 W HARRISON STCHICAGOILActive
DSH140119CBChildDSHRUSH UNIVERSITY MEDICAL CENTERRUMC OB GYNE - OB GYN MIGS - Clinic1725 W HARRISON STCHICAGOILActive
DSH140119CCChildDSHRUSH UNIVERSITY MEDICAL CENTERRUMC OB GYNE - OB GYN - Family Planning1725 W HARRISON STCHICAGOILActive
DSH140119CDChildDSHRUSH UNIVERSITY MEDICAL CENTERRUMC CARDIOLOGY HEART FAILURE - IM Cardiology Heart Failure PB1725 W HARRISON STCHICAGOILActive
DSH140119CEChildDSHRUSH UNIVERSITY MEDICAL CENTERROAD HOME PROGRAM: THE NATIONAL CEN - Road Home PHP/IOP - Clinic325 S PAULINA STCHICAGOILActive
DSH140119CFChildDSHRUSH UNIVERSITY MEDICAL CENTERRUMC ADULT PSYCH - Psych Rush Day Hosp - Clinic2150 W HARRISON STCHICAGOILActive
DSH140119CGChildDSHRUSH UNIVERSITY MEDICAL CENTERRUMC ADULT PSYCH - Psychiatry TMS - Clinic2150 W HARRISON STCHICAGOILActive
DSH140119CHChildDSHRUSH UNIVERSITY MEDICAL CENTERENT RAB - Clinic - ENT RAB - Clinic1520 W Harrison StChicagoILActive
DSH140119CJChildDSHRUSH UNIVERSITY MEDICAL CENTERIM Palliative - Clinic - IM Palliative - Clinic1725 West Harrison StreetChicagoILActive
DSH140119CKChildDSHRUSH UNIVERSITY MEDICAL CENTERRUSH NEPHROLOGY AND HYPERTENSION - IM Nephrology - Clinic1725 W HARRISON STCHICAGOILActive
DSH140119EChildDSHRUSH UNIVERSITY MEDICAL CENTERDHO AT RUSH OAK PARK HOSPITAL610 S. MAPLE AVENUEOAK PARKILActive
DSH140119FChildDSHRUSH UNIVERSITY MEDICAL CENTERNeurology Clinic1520 West Harrison StreetChicagoILActive
DSH140119GChildDSHRUSH UNIVERSITY MEDICAL CENTERMultiple Sclerosis Center Clinic1725 West Harrison StreetChicagoILActive
DSH140119HChildDSHRUSH UNIVERSITY MEDICAL CENTERNeurology Movement Disorders Clinic1725 West Harrison StreetChicagoILActive
DSH140119JChildDSHRUSH UNIVERSITY MEDICAL CENTERAsthma Comprehensive Center Clinic1611 W. Harrison StreetChicagoILTerminated
DSH140119KChildDSHRUSH UNIVERSITY MEDICAL CENTERBehavioral Sciences Clinic1645 W. Jackson BlvdChicagoILActive
DSH140119LChildDSHRUSH UNIVERSITY MEDICAL CENTERBehavioral Sciences Sleep Disorders Center Clinic710 S. PaulinaChicagoILActive
DSH140119MChildDSHRUSH UNIVERSITY MEDICAL CENTERGynecological Oncology Clinic1520 West Harrison StreetChicagoILActive
DSH140119NChildDSHRUSH UNIVERSITY MEDICAL CENTEROtolaryngology Head & Neck Surgery Clinic at ROPH610 South Maple AvenueOak ParkILActive
DSH140119PChildDSHRUSH UNIVERSITY MEDICAL CENTERRush Cancer Center Clinic1520 West Harrison StreetChicagoILActive
DSH140119QChildDSHRUSH UNIVERSITY MEDICAL CENTEREndocrinology Clinic1725 West Harrison StreetChicagoILActive
DSH140119RChildDSHRUSH UNIVERSITY MEDICAL CENTERAllergy and Immunology Clinic1725 West Harrison StreetChicagoILActive
DSH140119SChildDSHRUSH UNIVERSITY MEDICAL CENTERDermatology Clinic1725 West Harrison StreetChicagoILActive
DSH140119TChildDSHRUSH UNIVERSITY MEDICAL CENTERRheumatology Clinic1611 W. Harrison StreetChicagoILActive
DSH140119UChildDSHRUSH UNIVERSITY MEDICAL CENTERCardiology Clinic1725 West Harrison StreetChicagoILActive
DSH140119VChildDSHRUSH UNIVERSITY MEDICAL CENTERGeriatrics Clinic1725 West Harrison StreetChicagoILActive
DSH140119WChildDSHRUSH UNIVERSITY MEDICAL CENTERRush Cancer Comprehensive Center Clinic1520 West Harrison StreetChicagoILActive
DSH140119XChildDSHRUSH UNIVERSITY MEDICAL CENTERGastroenterology Clinic1520 West Harrison StreetChicagoILActive
DSH140119YChildDSHRUSH UNIVERSITY MEDICAL CENTERNeurology Epilepsy Clinic1520 W Harrison StChicagoILActive
DSH140119ZChildDSHRUSH UNIVERSITY MEDICAL CENTERRheumatology IM Clinic1611 W. Harrison StreetChicagoILActive
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification9/8/2023 1:15:26 PM9/6/2024 4:05:45 PM9/6/2024 4:05 PM
ContactsPrimary ContactUpdateChange RequestRichard, Angelique L SVP, Hospital Operations Rush University Medical Center 3125631124Kemper, Matthew Director, Clinical Operations Health Delivery Management, L.L.C. 31256323264/12/2024 2:49 PM
AddressesShipping AddressDeleteRecertificationRush Specialty Drug Solutions 1725 West Harrison Street Suite 104 Chicago, IL 60612 9/8/2023 1:15 PM
AddressesShipping AddressInsertRecertification Professional Office Building Pharmacy 1725 West Harrison Street Suite 418 Chicago, IL 606129/8/2023 1:15 PM
AddressesShipping AddressInsertRecertification Health Delivery Management, L.L.C. DBA Rush Cancer Center Pharmacy 1520 W Harrison St Rm 09115 Chicago, IL 606079/8/2023 1:15 PM
AddressesShipping AddressInsertRecertification Health Delivery Management, L.L.C. DBA Rush Pharmacy 1520 W Harrison St Rm 04071 Chicago, IL 606079/8/2023 1:15 PM
AddressesShipping AddressInsertRecertification Health Delivery Management LLC Rush Specialty Pharmacy 1520 W Harrison St Rm 04068 Chicago, IL 606079/8/2023 1:15 PM
AddressesShipping AddressInsertRecertification Home Infusion Solutions Pharmacy 610 S Maple Ave Ste 1200 Oak Park, IL 603049/8/2023 1:15 PM
AddressesShipping AddressDeleteRecertificationProfessional Office Building Pharmacy 1725 West Harrison Street Suite 418 Chicago, IL 60453 9/8/2023 1:15 PM
DetailsLast Recertification DateUpdateRecertification9/16/2022 11:02:29 AM9/8/2023 1:15:26 PM9/8/2023 1:15 PM
AddressesMain AddressUpdateChange Request 1725 West Harrison Street Suite 1118 Chicago, IL 60612 1520 West Harrison Street 7th Floor Chicago, IL 606073/16/2023 7:30 AM
DetailsLast Recertification DateUpdateRecertification8/27/2021 3:40:40 PM9/16/2022 11:02:29 AM9/16/2022 11:02 AM
DetailsLast Recertification DateUpdateRecertification8/26/2020 12:20:01 PM8/27/2021 3:40:40 PM8/27/2021 3:40 PM
Medicaid BillingNPI: NumberInsertRecertification 13261405838/26/2020 12:20 PM
Medicaid BillingNPI: StateInsertRecertification IL8/26/2020 12:20 PM
Medicaid BillingNPI: NumberInsertRecertification 18019087288/26/2020 12:20 PM
Medicaid BillingNPI: StateInsertRecertification IL8/26/2020 12:20 PM
Medicaid BillingNPI: NumberInsertRecertification 18514958998/26/2020 12:20 PM
Medicaid BillingNPI: StateInsertRecertification IL8/26/2020 12:20 PM
Medicaid BillingNPI: NumberInsertRecertification 19322136008/26/2020 12:20 PM
Medicaid BillingNPI: StateInsertRecertification IL8/26/2020 12:20 PM
Medicaid BillingNPI: NumberInsertRecertification 19322136008/26/2020 12:20 PM
Medicaid BillingNPI: StateInsertRecertification IN8/26/2020 12:20 PM
Medicaid BillingNPI: NumberInsertRecertification 19322136008/26/2020 12:20 PM
Medicaid BillingNPI: StateInsertRecertification WI8/26/2020 12:20 PM
Medicaid BillingNPI: NumberInsertRecertification 19322136008/26/2020 12:20 PM
Medicaid BillingNPI: StateInsertRecertification MI8/26/2020 12:20 PM
Medicaid BillingNPI: NumberInsertRecertification 19322136008/26/2020 12:20 PM
Medicaid BillingNPI: StateInsertRecertification MN8/26/2020 12:20 PM
Medicaid BillingNPI: NumberInsertRecertification 19322136008/26/2020 12:20 PM
Medicaid BillingNPI: StateInsertRecertification OH8/26/2020 12:20 PM
Medicaid BillingNPI: NumberInsertRecertification 19322136008/26/2020 12:20 PM
Medicaid BillingNPI: StateInsertRecertification FL8/26/2020 12:20 PM
Medicaid BillingNPI: NumberInsertRecertification 19322136008/26/2020 12:20 PM
Medicaid BillingNPI: StateInsertRecertification IA8/26/2020 12:20 PM
Medicaid BillingNPI: NumberInsertRecertification 19322136008/26/2020 12:20 PM
Medicaid BillingNPI: StateInsertRecertification AR8/26/2020 12:20 PM
Medicaid BillingNPI: NumberInsertRecertification 19322136008/26/2020 12:20 PM
Medicaid BillingNPI: StateInsertRecertification TN8/26/2020 12:20 PM
Medicaid BillingNPI: NumberDeleteRecertification1932213600 ( ) 8/26/2020 12:20 PM
Medicaid BillingNPI: NumberDeleteRecertification1801908728 ( ) 8/26/2020 12:20 PM
Medicaid BillingNPI: NumberDeleteRecertification1851495899 ( ) 8/26/2020 12:20 PM
Medicaid BillingNPI: NumberDeleteRecertification1326140583 ( ) 8/26/2020 12:20 PM
ContactsPrimary ContactUpdateRecertificationSonnenschein, Scott Vice President Hospital Operations Rush University Medical Center 3125632093Richard, Angelique L SVP, Hospital Operations Rush University Medical Center 31256311248/26/2020 12:20 PM
DetailsLast Recertification DateUpdateRecertification8/26/2019 12:54:14 PM8/26/2020 12:20:01 PM8/26/2020 12:20 PM
ContactsAuthorizing OfficialUpdateAO Change RequestMordach, John Chief Financial Officer Rush University Medical Center 3129425600ONeil, Patricia Steeves CFO Rush University Medical Center 31294256475/28/2020 2:43 PM
AddressesBilling AddressInsertChange Request Rush University Medical Center 1653 W Congress Pkwy Chicago, IL 606121/6/2020 9:54 AM
Medicaid BillingMedicaid: Is PrimaryInsertRecertification False8/26/2019 12:54 PM
Medicaid BillingMedicaid: NumberInsertRecertification 3621748230178/26/2019 12:54 PM
Medicaid BillingMedicaid: StateInsertRecertification IL8/26/2019 12:54 PM
Medicaid BillingMedicaid: Is PrimaryInsertRecertification False8/26/2019 12:54 PM
Medicaid BillingMedicaid: NumberInsertRecertification 3621748230058/26/2019 12:54 PM
Medicaid BillingMedicaid: StateInsertRecertification IL8/26/2019 12:54 PM
Medicaid BillingMedicaid: Is PrimaryInsertRecertification False8/26/2019 12:54 PM
Medicaid BillingMedicaid: NumberInsertRecertification 3621748230208/26/2019 12:54 PM
Medicaid BillingMedicaid: StateInsertRecertification IL8/26/2019 12:54 PM
Medicaid BillingMedicaid: NumberDeleteRecertification3048 (IL) 8/26/2019 12:54 PM
Medicaid BillingNPI: NumberDeleteRecertification1417043977 ( ) 8/26/2019 12:54 PM
DetailsLast Recertification DateUpdateRecertification8/22/2018 10:44:24 AM8/26/2019 12:54:14 PM8/26/2019 12:54 PM
AddressesShipping AddressInsertRecertification Rush Specialty Drug Solutions 1725 West Harrison Street Suite 104 Chicago, IL 606128/22/2018 10:44 AM
DetailsLast Recertification DateUpdateRecertification12/6/2017 9:36:35 AM8/22/2018 10:44:24 AM8/22/2018 10:44 AM
Medicaid BillingMedicaid: Is PrimaryInsertRecertification False12/6/2017 9:36 AM
Medicaid BillingMedicaid: NumberInsertRecertification 304812/6/2017 9:36 AM
Medicaid BillingMedicaid: StateInsertRecertification IL12/6/2017 9:36 AM
Medicaid BillingNPI: NumberInsertRecertification 193221360012/6/2017 9:36 AM
Medicaid BillingNPI: NumberInsertRecertification 180190872812/6/2017 9:36 AM
Medicaid BillingNPI: NumberInsertRecertification 141704397712/6/2017 9:36 AM
Medicaid BillingNPI: NumberInsertRecertification 185149589912/6/2017 9:36 AM
Medicaid BillingNPI: NumberInsertRecertification 132614058312/6/2017 9:36 AM
DetailsLast Recertification DateUpdateRecertification8/17/2016 12:00:00 AM12/6/2017 9:36:35 AM12/6/2017 9:36 AM
ContactsAuthorizing OfficialUpdate Mordach, John Chief Financial Officer 3129425600Mordach, John Chief Financial Officer Rush University Medical Center 312942560010/23/2017 10:40 AM
ContactsSigned ByUpdate Mordach, John Chief Financial Officer 3129425600Mordach, John Chief Financial Officer Rush University Medical Center 312942560010/23/2017 10:40 AM
ContactsPrimary ContactUpdate Sonnenschein, Scott Vice President Hospital Operations 3125632093Sonnenschein, Scott Vice President Hospital Operations Rush University Medical Center 312563209310/23/2017 10:32 AM
ContactsAuthorizing OfficialInsert  Mordach, John Chief Financial Officer 31294256008/10/2017 10:51 AM
ContactsSigned ByInsert  Mordach, John Chief Financial Officer 31294256008/10/2017 10:51 AM
ContactsPrimary ContactInsert  Sonnenschein, Scott Vice President Hospital Operations 31256320938/10/2017 9:58 AM
AddressesMain AddressInsert   1725 West Harrison Street Suite 1118 Chicago, IL 606128/17/2016 5:04 PM
DetailsLast Recertification DateUpdate 8/24/2015 12:00:00 AM8/17/2016 12:00:00 AM8/17/2016 5:04 PM
DetailsLast Recertification DateUpdate 9/8/2014 12:00:00 AM8/24/2015 12:00:00 AM8/24/2015 1:29 PM
AddressesShipping AddressInsert  Professional Office Building Pharmacy 1725 West Harrison Street Suite 418 Chicago, IL 604532/26/2015 5:59 PM
DetailsLast Recertification DateUpdate 8/22/2013 5:36:45 AM9/8/2014 12:00:00 AM9/8/2014 8:03 AM
DetailsLast Recertification DateUpdate  8/22/2013 5:36:45 AM8/22/2013 5:36 AM
Details340B IDUpdate IS-AP-DSH140119FDSH140119F8/17/2012 3:57 PM
DatesParticipating Approval DateUpdate  8/17/2012 12:00:00 AM8/17/2012 3:57 PM
DetailsStateUpdate PendingActive8/17/2012 3:57 PM
DatesStart DateUpdate  10/1/2012 12:00:00 AM8/17/2012 3:57 PM
Details340B IDUpdate AP062912BIS-AP-DSH140119F7/3/2012 9:24 AM
Details340B IDUpdate OUTPATIENT_ONLINE_REGAP062912B6/29/2012 7:17 AM
DetailsLast Recertification DateInsert   6/27/2012 11:11 AM
DetailsGrant NumberInsert   6/27/2012 11:11 AM
Details340B IDInsert  OUTPATIENT_ONLINE_REG6/27/2012 11:11 AM
DetailsIs Authorizing Official EHB DataInsert   6/27/2012 11:11 AM
DatesLast Date That 340B Drugs PurchasedInsert   6/27/2012 11:11 AM
DetailsMedicare Provider NumberInsert  1401196/27/2012 11:11 AM
DetailsEntity NameInsert  RUSH UNIVERSITY MEDICAL CENTER6/27/2012 11:11 AM
DetailsProgram CodeInsert  DSH6/27/2012 11:11 AM
DetailsEntity SubnameInsert  Neurology Clinic6/27/2012 11:11 AM
DatesParticipating Approval DateInsert   6/27/2012 11:11 AM
DetailsStateInsert  Pending6/27/2012 11:11 AM
DatesRegistration DateInsert  6/27/2012 12:00:00 AM6/27/2012 11:11 AM
DatesSigned By DateInsert  6/27/2012 12:00:00 AM6/27/2012 11:11 AM
DatesStart DateInsert   6/27/2012 11:11 AM
TerminationsTermination CommentsInsert   6/27/2012 11:11 AM
TerminationsTermination DateInsert   6/27/2012 11:11 AM
TerminationsTermination Effective DateInsert   6/27/2012 11:11 AM
TerminationsTermination ReasonInsert   6/27/2012 11:11 AM