340B Drug Pricing Program Database


CHC24103-01 Esperanza Health Centers (Active) - information as of 4/28/2025 12:39:20 AM

Main Details
Esperanza Health Centers
Esperanza California, Suite 101
HRSA-Funded Health Center
BPS-H80-012208
CHC24103-01
H80CS24103


Additional Details
Active
1/24/2013
4/1/2013
1/24/2013
2/12/2025

Contacts

Esperanza Health Centers
Ryan Gadia, CFO
(773) 640-5792

Esperanza Health Centers
Dan Barona, 340B Financial Analyst
(773) 584-6141

Addresses

2001 S. California Ave. STE 101
Chicago, IL 60608-2405

Esperanza Health Centers
1940 S Western Ave
205
Chicago, IL 60608


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

Yes
StateMedicaid NumberNPI Number
IL320115907002,320115907003,320115907004,320115907005,3201159070061124187125,1477812030,1669812582
Shipping Addresses

Esperanza Health Centers
2001 S. California Ave. STE 100
Chicago, IL 60608
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailSURECARE DISCOUNT PHARMACY INCDBA:SURECARE PHARMACY IL 4700 S CALIFORNIA AVE
CHICAGOIL6063210/13/202301/01/2024  01/01/2024
Contract DetailSURECARE PHARMACY INC.2001 S CALIFORNIA AVE SUITE 103
CHICAGOIL60608-248603/18/201304/01/2013 12/31/202312/31/2023
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CHC24103-00ActiveBPS-H80-011604Esperanza Health CentersEsperanza California2001 S California Ave STE 100 ChicagoIL
CHC24103-01ActiveBPS-H80-012208Esperanza Health CentersEsperanza California, Suite 1012001 S. California Ave. STE 101 ChicagoIL
CHC24103-02ActiveBPS-H80-012782Esperanza Health CentersEsperanza Little Village3059 W 26th St ChicagoIL
CHC24103-03ActiveBPS-H80-012783Esperanza Health CentersEsperanza Marquette6550 S Richmond St ChicagoIL
CHC24103-04ActiveBPS-H80-027306Esperanza Health CentersEsperanza Brighton Park4700 S California Ave ChicagoIL
CHC24103-05TerminatedBPS-H80-031714Esperanza Health CentersEsperanza Vida Pediatrics3124 W 59th St ChicagoIL
CHC24103-06ActiveBPS-H80-037254Esperanza Health CentersEsperanza at Cultivate Collective4350 S Laporte Ave ChicagoIL
CHC24103-07ActiveBPS-H80-034458Esperanza Health CentersEsperanza at 63rd4058 W 63rd St ChicagoIL
CHC24103-08ActiveBPS-H80-032213Esperanza Health CentersEsperanza at Charles G. Hammond Elementary School2819 W 21st Pl Rm 300 ChicagoIL
CHC24103-09ActiveBPS-H80-034459ESPERANZA HEALTH CENTERSEsperanza Academy for Global Citizenship Annex4941 W 46th St RM 100 ChicagoIL
CHC24103-10TerminatedBPS-H80-035806ESPERANZA HEALTH CENTERSEsperanza at Saucedo Scholastic Academy2850 W 24th Blvd RM 104 ChicagoIL
CHC24103-11TerminatedBPS-H80-035746ESPERANZA HEALTH CENTERSEsperanza at Spry Community School2400 S Marshall Blvd RM 214 ChicagoIL
CHC24103-12ActiveBPS-H80-033814ESPERANZA HEALTH CENTERSEsperanza Brighton Park Campus Expansion4720 S California Ave ChicagoIL
CHC24103-13ActiveBPS-H80-037254ESPERANZA HEALTH CENTERSEsperanza at Cultivate Collective4350 S Laporte Ave ChicagoIL
CHC24103-14TerminatedBPS-H80-038493ESPERANZA HEALTH CENTERSTemporary Site - Parthenon Shelter310 S Halsted St ChicagoIL
CHC24103-15TerminatedBPS-H80-038495ESPERANZA HEALTH CENTERSTemporary Site - Lakeshore Hotel Shelter4900 S Lake Shore Dr ChicagoIL
CHC24103-16TerminatedBPS-H80-038494ESPERANZA HEALTH CENTERSTemporary Site - Daley College Shelter7500 S Pulaski Rd ChicagoIL
CHC24103-17TerminatedBPS-H80-038496ESPERANZA HEALTH CENTERSTemporary Site - Social Club Shelter320 S Plymouth Ct ChicagoIL
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CHC24103-00ACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750204/01/2024  
CHC24103-00ACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201004/01/2024  
CHC24103-00ACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884904/01/2024  
CHC24103-00ACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349204/01/2024  
CHC24103-00ACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282204/01/2024  
CHC24103-00ACCREDO HEALTH GROUP, INC.4750 E 450 S SUITE A
WHITESTOWNIN4607504/01/2024  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS LLCDBA: WALGREENS #12150 5158 N. LINCOLN AVE
CHICAGOIL6062504/01/2013  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 01417 1931 W CERMAK RD
CHICAGOIL6060804/01/2013  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 02903 5222 WEST MADISON ST
CHICAGOIL6064404/01/2013  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03395 3401 W ROOSEVELT RD
CHICAGOIL6062404/01/2013  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03961 2340 W MADISON ST
CHICAGOIL6061204/01/2013 11/12/2024
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04008 540 25TH AVENUE
BELLWOODIL6010404/01/2013 07/17/2015
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04148 7960 W. 159TH ST.
ORLAND PARKIL6046204/01/2013 03/03/2018
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04461 501 W ROOSEVELT RD
CHICAGOIL6060704/01/2013  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04519 1320 E 47TH ST.
CHICAGOIL6065304/01/2013  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04936 4040 N. CICERO AVE.
CHICAGOIL6064104/01/2013  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04938 4748 W NORTH AVE
CHICAGOIL6063904/01/2013  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04978 111 S. HALSTED STREET
CHICAGOIL6066104/01/2013  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05034 6315 S KEDZIE AVE
CHICAGOIL6062904/01/2013  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05076 6800 OGDEN AVE
BERWYNIL6040204/01/2013  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05104 5525 159TH ST
OAK FORESTIL6045204/01/2013 03/03/2018
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05147 9150 SKOKIE BLVD
SKOKIEIL6007704/01/2013 03/03/2018
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05149 1600 W. ROOSEVELT RD
BROADVIEWIL6015504/01/2013 03/03/2018
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05234 5435 S KEDZIE AVE
CHICAGOIL6063204/01/2013  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05356 4710 S WESTERN AVE
CHICAGOIL6060904/01/2013  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS #13454 6140 N WESTERN AVE
CHICAGOIL6065904/01/2013  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05103 5932 W. CERMAK RD
CICEROIL6080407/01/2016 11/01/2024
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 01503 1926 W 35TH ST
CHICAGOIL6060910/01/2018  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS #11492 5414 S. ARCHER AVE
CHICAGOIL60638-300210/01/2018  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 02025 3000 S HALSTED
CHICAGOIL6060804/01/2019  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05089 7111 S WESTERN AVE
CHICAGOIL6063604/01/2019 02/17/2025
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04009 4730 BUTTERFIELD ROAD
HILLSIDEIL6016201/01/2020  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04948 101 LILY CACHE LANE
BOLINGBROOKIL6044001/01/2020  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03995 6 E NORTH AVE
NORTHLAKEIL6016404/01/2020  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 02840 1500 W WILSON AVE
CHICAGOIL6064001/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05126 3564 RIDGE RD
LANSINGIL6043801/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05104 5525 159TH ST
OAK FORESTIL6045201/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05235 6412 ROOSEVELT RD
OAK PARKIL60304-213501/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 01310 3110 W ARMITAGE
CHICAGOIL6064701/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04306 1633 W. 95TH STREET
CHICAGOIL6064301/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 02711 7150 W ARCHER AVE
CHICAGOIL6063801/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03074 4700 S. HALSTED ST
CHICAGOIL6060901/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 02785 5840 WEST 35TH ST
CICEROIL6080401/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04494 1649 W. BELMONT AVENUE
CHICAGOIL6065701/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05468 16 E LAKE ST
ADDISONIL6010101/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 11109 4800 148TH STREET
MIDLOTHIANIL60445-311701/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05139 7945 W 95TH ST
HICKORY HILLSIL6045704/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 11410 1627 N PULASKI RD
CHICAGOIL6063904/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 02877 2440 W NORTH AVE
CHICAGOIL6064704/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04460 1295 LILY CACHE LANE
BOLINGBROOKIL6049004/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS #15635 3959 W. 95TH ST.
EVERGREEN PARKIL6080504/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05127 18133 TORRENCE AVE
LANSINGIL6043804/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 01308 7410 N CLARK
CHICAGOIL6062604/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS #15080 5555 WEST 79TH ST
BURBANKIL6045904/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04147 1546 N. CENTRAL AVE.
CHICAGOIL60651-125904/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05055 12290 S PULASKI RD
ALSIPIL6080304/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04752 316 W. CERMAK ROAD
CHICAGOIL6061604/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.WALGREENS # 16525 5401 S WENTWORTH AVE
SUITE 5A1 		CHICAGOIL6060907/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 04233 5600 W. FULLERTON
CHICAGOIL6063910/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05193 3145 W 147TH ST
POSENIL6046910/01/2022  
CHC24103-00BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 03729 7350 BARRINGTON RD.
HANOVER PARKIL6013304/01/2023  
CHC24103-03BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05034 6315 S KEDZIE AVE
CHICAGOIL6062904/01/2023  
CHC24103-04BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05234 5435 S KEDZIE AVE
CHICAGOIL6063201/01/2024  
CHC24103-07BOND DRUG COMPANY OF ILLINOIS, L.L.C.DBA: WALGREENS # 05356 4710 S WESTERN AVE
CHICAGOIL6060901/01/2024  
CHC24103-00CAREKINESIS228 STRAWBRIDGE DR STE 200
MOORESTOWNNJ08057-460007/01/2024  
CHC24103-00CAREKINESISSUITE 100 5303 SPINE RD
BOULDERCO80301-330007/01/2024  
CHC24103-00CAREKINESIS401 S CANAL ST
SOUTH SAN FRANCISCOCA94080-460607/01/2024  
CHC24103-00CAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361404/01/2023  
CHC24103-00CAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005604/01/2023  
CHC24103-00CAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621904/01/2023  
CHC24103-00CAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175704/01/2023  
CHC24103-00CAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808304/01/2023  
CHC24103-00CAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700404/01/2023  
CHC24103-00CAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761704/01/2023  
CHC24103-00CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813304/01/2023  
CHC24103-00CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A 		REDLANDSCA9237404/01/2023  
CHC24103-00CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911904/01/2023  
CHC24103-00CVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502804/01/2023  
CHC24103-00CYSTIC FIBROSIS SERVICES, LLCDBA WALGREENS SPECIALTY PHARMACY #16280 10530 JOHN W ELLIOTT DR STE 200
FRISCOTX7503301/01/2020  
CHC24103-00ESI MAIL PHARMACY SERVICEDBA EXPRESS SCRIPTS 7909 S HARDY DR STE 106
TEMPEAZ85284-111204/01/2024  
CHC24103-00EXACT CARE PHARMACYDDCRX, LLC 2701 HIGHPOINT OAKS DR STE 100
LEWISVILLETX75067-389607/01/2024  
CHC24103-00EXACT CARE PHARMACY, LLC8333 ROCKSIDE RD
CLEVELANDOH4412507/01/2024  
CHC24103-00EXPRESS SCRIPTSESI MAIL PHARMACY SERVICE INC 4600 N HANLEY RD
SAINT LOUISMO6313404/01/2024  
CHC24103-00EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801604/01/2024  
CHC24103-00EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607504/01/2024  
CHC24103-00HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 02846 8639 S. CICERO AVE.
CHICAGOIL6065210/01/2022 01/17/2024
CHC24103-00HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 16285 7100 S CICERO AVE
CHICAGOIL6062910/01/2022  
CHC24103-00HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 16219 2901 S CICERO AVE
CICEROIL6080410/01/2022  
CHC24103-00HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08741 2634 S PULASKI
CHICAGOIL6062310/01/2022 10/01/2022
CHC24103-00HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17166 1940 W 33RD ST
CHICAGOIL6060810/01/2022  
CHC24103-00HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 04793 1211 W. ROOSEVELT RD.
CHICAGOIL6060810/01/2022  
CHC24103-00HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08742 5524 W CERMAK RD, STE 1
CICEROIL6080410/01/2022  
CHC24103-00HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08502 6315 S PULASKI RD STE 1
CHICAGOIL6062910/01/2022  
CHC24103-00HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 16999 4433 S PULASKI RD
CHICAGOIL6063210/01/2022  
CHC24103-11HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17166 1940 W 33RD ST
CHICAGOIL6060801/01/2024 04/01/2024
CHC24103-08HIGHLAND PARK CVS, L.L.C.DBA: CVS/PHARMACY # 08502 6315 S PULASKI RD STE 1
CHICAGOIL6062901/01/2024  
CHC24103-09HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 16999 4433 S PULASKI RD
CHICAGOIL6063201/01/2024  
CHC24103-00HIGHLAND PARK CVS, L.L.C.CVS PHARMACY # 17175 4120 W 95TH ST
OAK LAWNIL6045304/01/2024  
CHC24103-00PRIME THERAPEUTICS SPECIALTY PHARMACY LLALLIANCERX WALGREENS PRIME #16568 2354 COMMERCE PARK DRIVE
SUITE 100 		ORLANDOFL32819-999201/01/2020 10/06/2022
CHC24103-00PROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514604/01/2023  
CHC24103-00PROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523304/01/2023  
CHC24103-00PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY OR CARELONRX SPECIALTY ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1 		HONOLULUHI9681304/01/2023  
CHC24103-00PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920304/01/2023  
CHC24103-00SURECARE 2 INC.DBA SURECARE PHARMACY CHICAGO 4104 W 63RD ST
CHICAGOIL6062901/01/2023  
CHC24103-00SURECARE DISCOUNT PHARMACY INCDBA:SURECARE PHARMACY IL 4700 S CALIFORNIA AVE
CHICAGOIL6063210/01/2019  
CHC24103-04SURECARE DISCOUNT PHARMACY INCDBA:SURECARE PHARMACY IL 4700 S CALIFORNIA AVE
CHICAGOIL6063204/01/2023 12/31/2023
CHC24103-01SURECARE DISCOUNT PHARMACY INCDBA:SURECARE PHARMACY IL 4700 S CALIFORNIA AVE
CHICAGOIL6063201/01/2024  
CHC24103-00SURECARE PHARMACY INC.2001 S CALIFORNIA AVE SUITE 103
CHICAGOIL60608-248604/01/2013  
CHC24103-01SURECARE PHARMACY INC.2001 S CALIFORNIA AVE SUITE 103
CHICAGOIL60608-248604/01/2013 12/31/2023
CHC24103-00WALGREEN CODBA: WALGREENS #15525 201 E. HURON STREET, SUITE 01-210
CHICAGOIL6061110/01/2019  
CHC24103-00WALGREEN CODBA: WALGREENS #10374 680 E. BOUGHTON RD
BOLINGBROOKIL6044001/01/2022  
CHC24103-00Walgreen CODBA Walgreens Central Fill #21417 599 S Schmidt Rd
Ste A 		BolingbrookIL60440-940504/01/2023  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 00163 4000 W 59TH ST
CHICAGOIL6062904/01/2013  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 00215 3045 W 26TH STREET
CHICAGOIL6062304/01/2013  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 00226 4005 W 26TH STREET
CHICAGOIL6062304/01/2013 02/18/2025
CHC24103-00WALGREEN CO.DBA: WALGREENS # 01249 4800 W CERMAK RD
CICEROIL6080404/01/2013  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 03321 5874 S ARCHER AVENUE
CHICAGOIL60638-164504/01/2013  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 05724 7045 S PULASKI ROAD
CHICAGOIL60629-583304/01/2013  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 05825 1213 W 79TH STREET
CHICAGOIL60620-370604/01/2013  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 05867 3943 W 47TH STREET
CHICAGOIL60632-414504/01/2013  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 05868 3798 SOUTH WESTERN AVE
CHICAGOIL60609-101404/01/2013 07/17/2015
CHC24103-00WALGREEN CO.DBA: WALGREENS # 05926 4385 S ARCHER AVE
CHICAGOIL6063204/01/2013  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 06297 6016 W 63RD STREET
CHICAGOIL60638-431804/01/2013  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 06462 9595 GRAND AVE
FRANKLIN PARKIL6013104/01/2013 03/03/2018
CHC24103-00WALGREEN CO.DBA: WALGREENS # 06641 1614 W 47TH STREET
CHICAGOIL60609-324504/01/2013  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 07359 3222 N. MILWAUKEE AVENUE
CHICAGOIL60618-510604/01/2013  
CHC24103-00WALGREEN CO.WALGREENS SPECIALTY PHARMACY #15305 912 W BELMONT AVE
CHICAGOIL6065707/01/2016  
CHC24103-00WALGREEN CO.DBA: WALGREENS #15506 3303 W. 26TH STREET
SUITE 101 		CHICAGOIL6062310/01/2018  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 11154 7113 CERMAK RD
BERWYNIL6040204/01/2019  
CHC24103-00WALGREEN CO.DBA WALGREENS #16093 3040 S. CICERO AVE.
SUITE A 		CICEROIL6080410/01/2019  
CHC24103-00WALGREEN CO.WALGREENS SPECIALTY PHARMACY #13832 4339 DIPAOLO CENTER
GLENVIEWIL6002501/01/2020  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 00089 8715 S HARLEM AVE
BRIDGEVIEWIL6045501/01/2020  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 10649 3424 W BELMONT AVE
CHICAGOIL6061801/01/2020  
CHC24103-00WALGREEN CO.DBA: WALGREENS #15196 151 N. STATE ST.
CHICAGOIL60601-360101/01/2020  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 09038 4001 W IRVING PARK RD
CHICAGOIL60641-292601/01/2020  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 09709 4010 W LAWRENCE AVE
CHICAGOIL6063004/01/2020  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 01096 3646 N BROADWAY
CHICAGOIL6061304/01/2020  
CHC24103-00WALGREEN CO.DBA: WALGREENS #13966 3249 S. OAK PARK AVE STE T1201
BERWYNIL6040204/01/2020 09/21/2020
CHC24103-00WALGREEN CO.DBA: WALGREENS #13975 711 W NORTH AVE STE #204
CHICAGOIL6061010/01/2021 09/18/2023
CHC24103-00WALGREEN CO.DBA: WALGREENS #15460 4440 WEST 95TH STREET SUITE 0201P
OAK LAWNIL6045310/01/2021 04/02/2024
CHC24103-00WALGREEN CO.UNITE HERE HEALTH PHARMACY 218 S WABASH AVE
STE 400RX 		CHICAGOIL60604-244410/01/2021  
CHC24103-00WALGREEN CO.DBA: WALGREENS #15507 3800 W MADISON STREET SUITE 101
CHICAGOIL6062410/01/2021  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 05124 8628 S COTTAGE GROVE AVE
CHICAGOIL6061901/01/2022  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 09141 8700 S KEDZIE AVE
EVERGREEN PARKIL60805-102401/01/2022  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 00258 1650 W CHICAGO AVE
CHICAGOIL6062201/01/2022  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 05713 4740 W. 95TH STREET
OAK LAWNIL6045301/01/2022  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 06980 3019 W PETERSON AVE
CHICAGOIL60659-341701/01/2022  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 06629 8701 S CICERO AVE
HOMETOWNIL60456-101801/01/2022  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 13106 11801 S. AVENUE O
CHICAGOIL6061701/01/2022  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 07179 2 E ROOSEVELT RD
CHICAGOIL60605-241001/01/2022  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 09600 1445 W NORTH AVE
MELROSE PARKIL6016001/01/2022  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 00178 740 W DIVERSEY PKWY
CHICAGOIL6061401/01/2022  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 06762 11833 S WESTERN AVE
CHICAGOIL60643-473401/01/2022  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 07250 2345 W 103RD STREET
CHICAGOIL60643-242301/01/2022  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 01450 4101 1ST AVE
LYONSIL6053401/01/2022  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 09000 2001 N MILWAUKEE AVE
CHICAGOIL60647-400101/01/2022  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 03710 15575 E 127TH STREET
LEMONTIL6043901/01/2022  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 10350 7109 S JEFFERY BLVD
CHICAGOIL60649-242501/01/2022 02/27/2025
CHC24103-00WALGREEN CO.DBA: WALGREENS # 00147 3611 E 106TH ST
CHICAGOIL6061701/01/2022  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 09470 4817 W FULLERTON AVE
CHICAGOIL60639-250304/01/2022  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 04462 6510 COLUMBIA AVE.
HAMMONDIN4632004/01/2022  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 00194 4801 N LINCOLN AVE
CHICAGOIL6062504/01/2022  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 05684 8800 W 95TH ST
HICKORY HILLSIL6045704/01/2022  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 06427 7878 S HARLEM AVE
BRIDGEVIEWIL6045504/01/2022  
CHC24103-00WALGREEN CO.WALGREENS SPECIALTY PHARMACY #16498 2351 E 71ST ST
SUITE A 		CHICAGOIL6064907/01/2022  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 05192 9148 S COMMERCIAL AVE
CHICAGOIL6061710/01/2022 02/20/2025
CHC24103-00WALGREEN CO.DBA: WALGREENS # 00162 1554 E 55TH ST
CHICAGOIL6061504/01/2023  
CHC24103-00WALGREEN CO.DBA: WALGREENS #15197 6121 N BROADWAY ST.
CHICAGOIL6066004/01/2023  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 01449 8000 BROADVIEW VILLAGE SQUARE
BROADVIEWIL60155-260104/01/2023  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 00259 3358 N WESTERN
CHICAGOIL6061804/01/2023  
CHC24103-00WALGREEN CO.DBA: WALGREENS # 00232 3405 S KING DR
CHICAGOIL6061604/01/2023 02/26/2025
CHC24103-02WALGREEN CO.DBA: WALGREENS # 00215 3045 W 26TH STREET
CHICAGOIL6062304/01/2023  
CHC24103-10WALGREEN CO.DBA: WALGREENS # 06641 1614 W 47TH STREET
CHICAGOIL60609-324501/01/2024 04/01/2024
CHC24103-06WALGREEN CO.DBA: WALGREENS # 05926 4385 S ARCHER AVE
CHICAGOIL6063201/01/2024  
CHC24103-00WALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
TEMPEAZ8528407/01/2013 07/08/2015
CHC24103-00WALGREENS MAIL SERVICE, INC.  8337 S PARK CIRCLE
ORLANDOFL32819-904907/01/2013 07/08/2015
CHC24103-00WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527501/01/2020  
CHC24103-00WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818801/01/2020  
CHC24103-00WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503301/01/2020  
CHC24103-00WALGREENS SPECIALTY PHARMACY, LLCALLIANCERX WALGREENS PRIME #12314 9775 SW GEMINI DR, STE 1
BEAVERTONOR9700801/01/2020 10/01/2021
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
ContactsPrimary ContactUpdateGroup Change RequestSpreitzer, Zachary Director of Finance Esperanza Health Centers 7734821966-4501Barona, Dan 340B Financial Analyst Esperanza Health Centers 77358461414/9/2025 9:01 AM
DetailsLast Recertification DateUpdateRecertification2/5/2024 8:44:37 PM2/12/2025 3:17:17 PM2/12/2025 3:17 PM
DetailsLast Recertification DateUpdateRecertification2/8/2023 11:48:46 AM2/5/2024 8:44:37 PM2/5/2024 8:44 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False7/3/2023 2:14 PM
Medicaid BillingMedicaid: NumberInsertChange Request 3201159070027/3/2023 2:14 PM
Medicaid BillingMedicaid: StateInsertChange Request IL7/3/2023 2:14 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False7/3/2023 2:14 PM
Medicaid BillingMedicaid: NumberInsertChange Request 3201159070037/3/2023 2:14 PM
Medicaid BillingMedicaid: StateInsertChange Request IL7/3/2023 2:14 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False7/3/2023 2:14 PM
Medicaid BillingMedicaid: NumberInsertChange Request 3201159070047/3/2023 2:14 PM
Medicaid BillingMedicaid: StateInsertChange Request IL7/3/2023 2:14 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False7/3/2023 2:14 PM
Medicaid BillingMedicaid: NumberInsertChange Request 3201159070057/3/2023 2:14 PM
Medicaid BillingMedicaid: StateInsertChange Request IL7/3/2023 2:14 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False7/3/2023 2:14 PM
Medicaid BillingMedicaid: NumberInsertChange Request 3201159070067/3/2023 2:14 PM
Medicaid BillingMedicaid: StateInsertChange Request IL7/3/2023 2:14 PM
Medicaid BillingMedicaid: NumberDeleteChange Request1669812582 (IL) 7/3/2023 2:14 PM
Medicaid BillingMedicaid: NumberDeleteChange Request1477812030 (IL) 7/3/2023 2:14 PM
Medicaid BillingMedicaid: NumberDeleteChange Request1124187125 (IL) 7/3/2023 2:14 PM
Medicaid BillingNPI: NumberInsertChange Request 11241871257/3/2023 2:14 PM
Medicaid BillingNPI: StateInsertChange Request IL7/3/2023 2:14 PM
Medicaid BillingNPI: NumberInsertChange Request 14778120307/3/2023 2:14 PM
Medicaid BillingNPI: StateInsertChange Request IL7/3/2023 2:14 PM
Medicaid BillingNPI: NumberInsertChange Request 16698125827/3/2023 2:14 PM
Medicaid BillingNPI: StateInsertChange Request IL7/3/2023 2:14 PM
DetailsLast Recertification DateUpdateRecertification2/2/2022 6:29:24 PM2/8/2023 11:48:46 AM2/8/2023 11:48 AM
DetailsEntity NameUpdateRecertificationCENTRO DE SALUD Y ESPERANZAEsperanza Health Centers2/8/2023 11:48 AM
DetailsEntity SubnameUpdateRecertificationCentro de Salud Esperanza, Suite 101Esperanza California, Suite 1012/8/2023 11:48 AM
ContactsAuthorizing OfficialUpdateGroup Change RequestFulwiler, Dan CEO Esperanza Health Centers 7735846200Gadia, Ryan CFO Esperanza Health Centers 77364057925/6/2022 9:09 AM
ContactsPrimary ContactUpdateGroup Change RequestGadia, Ryan CFO Esperanza Health Centers 7736405792Spreitzer, Zachary Director of Finance Esperanza Health Centers 7734821966-45015/6/2022 9:09 AM
DetailsLast Recertification DateUpdateRecertification2/4/2021 4:44:52 PM2/2/2022 6:29:24 PM2/2/2022 6:29 PM
AddressesBilling AddressUpdateGroup Change RequestEsperanza Health Centers 1940 S Western Ave # 205 Chicago, IL 60608Esperanza Health Centers 1940 S Western Ave 205 Chicago, IL 606088/17/2021 9:35 AM
AddressesBilling AddressInsertChange Request Esperanza Health Centers 1940 S Western Ave # 205 Chicago, IL 606085/11/2021 11:48 AM
DetailsLast Recertification DateUpdateRecertification1/30/2020 10:49:05 AM2/4/2021 4:44:52 PM2/4/2021 4:44 PM
DetailsLast Recertification DateUpdateRecertification1/29/2019 4:52:26 PM1/30/2020 10:49:05 AM1/30/2020 10:49 AM
ContactsPrimary ContactUpdateProfile Change RequestGadia, Ryan Controller Esperanza Health Centers 7736405792Gadia, Ryan CFO Esperanza Health Centers 77364057927/16/2019 4:21 PM
DetailsLast Recertification DateUpdateRecertification2/8/2018 2:17:21 PM1/29/2019 4:52:26 PM1/29/2019 4:52 PM
AddressesShipping AddressInsertChange Request Esperanza Health Centers 2001 S. California Ave. STE 100 Chicago, IL 6060811/2/2018 8:25 AM
DetailsLast Recertification DateUpdateRecertification2/8/2017 12:00:00 AM2/8/2018 2:17:21 PM2/8/2018 2:17 PM
ContactsPrimary ContactUpdateChange RequestFulwiler, Dan CEO Esperanza Health Centers 7735846200Gadia, Ryan Controller Esperanza Health Centers 77364057921/26/2018 10:24 AM
ContactsAuthorizing OfficialUpdate Fulwiler, Dan CEO 7735846200Fulwiler, Dan CEO Esperanza Health Centers 77358462001/26/2018 10:17 AM
ContactsPrimary ContactUpdate Fulwiler, Dan CEO 7735846200Fulwiler, Dan CEO Esperanza Health Centers 77358462001/26/2018 10:17 AM
AddressesMain AddressInsert   2001 S. California Ave. STE 101 Chicago, IL 60608-24052/8/2017 9:20 AM
ContactsAuthorizing OfficialInsert  Fulwiler, Dan CEO 77358462002/8/2017 9:20 AM
ContactsPrimary ContactInsert  Fulwiler, Dan CEO 77358462002/8/2017 9:20 AM
DetailsLast Recertification DateUpdate 2/25/2016 12:00:00 AM2/8/2017 12:00:00 AM2/8/2017 9:20 AM
Medicaid BillingMedicaid: Is PrimaryInsert  False2/25/2016 12:46 PM
Medicaid BillingMedicaid: NumberInsert  16698125822/25/2016 12:46 PM
Medicaid BillingMedicaid: StateInsert  IL2/25/2016 12:46 PM
Medicaid BillingMedicaid: Is PrimaryInsert  False2/25/2016 12:46 PM
Medicaid BillingMedicaid: NumberInsert  14778120302/25/2016 12:46 PM
Medicaid BillingMedicaid: StateInsert  IL2/25/2016 12:46 PM
Medicaid BillingMedicaid: Is PrimaryInsert  False2/25/2016 12:46 PM
Medicaid BillingMedicaid: NumberInsert  11241871252/25/2016 12:46 PM
Medicaid BillingMedicaid: StateInsert  IL2/25/2016 12:46 PM
DetailsLast Recertification DateUpdate 1/28/2015 12:00:00 AM2/25/2016 12:00:00 AM2/25/2016 12:46 PM
DetailsLast Recertification DateUpdate 3/18/2014 12:00:00 AM1/28/2015 12:00:00 AM1/28/2015 3:06 PM
DetailsLast Recertification DateUpdate  3/18/2014 12:00:00 AM3/18/2014 11:18 PM
DetailsEntity NameUpdate Centro de Salud Y EsperanzaCENTRO DE SALUD Y ESPERANZA3/18/2014 11:18 PM
Details340B IDUpdate IS-FN-CHC24103ACHC24103-011/24/2013 5:50 PM
DatesParticipating Approval DateUpdate  1/24/2013 12:00:00 AM1/24/2013 5:50 PM
DetailsStateUpdate PendingActive1/24/2013 5:50 PM
DetailsLast Recertification DateInsert   1/24/2013 5:37 PM
DetailsGrant NumberInsert  H80CS241031/24/2013 5:37 PM
Details340B IDInsert  IS-FN-CHC24103A1/24/2013 5:37 PM
DetailsIs Authorizing Official EHB DataInsert   1/24/2013 5:37 PM
DatesLast Date That 340B Drugs PurchasedInsert   1/24/2013 5:37 PM
DetailsMedicare Provider NumberInsert   1/24/2013 5:37 PM
DetailsEntity NameInsert  Centro de Salud Y Esperanza1/24/2013 5:37 PM
DetailsProgram CodeInsert  CH1/24/2013 5:37 PM
DetailsEntity SubnameInsert  Centro de Salud Esperanza, Suite 1011/24/2013 5:37 PM
DatesParticipating Approval DateInsert   1/24/2013 5:37 PM
DetailsStateInsert  Pending1/24/2013 5:37 PM
DatesRegistration DateInsert  1/24/2013 12:00:00 AM1/24/2013 5:37 PM
DatesSigned By DateInsert   1/24/2013 5:37 PM
DatesStart DateInsert  4/1/2013 12:00:00 AM1/24/2013 5:37 PM
TerminationsTermination CommentsInsert   1/24/2013 5:37 PM
TerminationsTermination DateInsert   1/24/2013 5:37 PM
TerminationsTermination Effective DateInsert   1/24/2013 5:37 PM
TerminationsTermination ReasonInsert   1/24/2013 5:37 PM