Covered Entity Details

FP60610 Planned Parenthood of Illinois (Terminated) - information as of 6/4/2025 12:08:01 PM

Main Details

Name

Planned Parenthood of Illinois

Subdivision Name

Near North Health Center

Type

Family Planning (Title X only)

340B ID

FP60610

Grant Number

FPHPA006456-01-00

Additional Details

Current Program Status

Terminated

Registration Date

10/1/2015

Participating Start Date

1/1/2016

Participating Approval Date

11/19/2015

Last Recertification Date

6/7/2019

Termination Date
Termination Reason

1/6/2020
Loss of qualifying grant/support

Contacts

Authorizing Official

Planned Parenthood of Illinois
Richard Powell, Chief Financial Officer
(312) 592-6878

Primary Contact

Planned Parenthood of Illinois
Emily K Glover, Vice President of Patient Services
(312) 592-6800 Ext: 6854

Addresses

Street Address

1200 N LaSalle Ave
Chicago, IL 60610

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
IL	362170901004
		1790754745

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
Contract Detail	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04779	1799 DOUGLAS RD	MONTGOMERY	IL	60538	10/01/2019	01/01/2020		01/06/2020	01/06/2020
Contract Detail	WALGREEN CO.	DBA: WALGREENS #15168	602 W. UNIVERSITY AVENUE	URBANA	IL	61801	10/01/2019	01/01/2020		01/06/2020	01/06/2020

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Primary Contact	Update	Profile Change Request	Glover, Emily K Senior Director, Patient Services Planned Parenthood of Illinois 3125926800-6854	Glover, Emily K Vice President of Patient Services Planned Parenthood of Illinois 3125926800-6854	1/14/2025 2:17 PM
Contacts	Primary Contact	Update	Profile Change Request	Glover, Emily R Senior Director, Patient Services Planned Parenthood of Illinois 3125926800-6854	Glover, Emily K Senior Director, Patient Services Planned Parenthood of Illinois 3125926800-6854	1/14/2025 2:17 PM
Contacts	Primary Contact	Update	AO Change Request	Glover, Emily Senior Director, Patient Services Planned Parenthood of Illinois 3125926800-6854	Glover, Emily R Senior Director, Patient Services Planned Parenthood of Illinois 3125926800-6854	10/25/2024 7:57 AM
Contacts	Primary Contact	Update	New Registration	Glover, Emily Senior Director, Patient Services Planned Parenthood of Illinois 3125926800	Glover, Emily Senior Director, Patient Services Planned Parenthood of Illinois 3125926800-6854	5/18/2020 9:48 AM
Dates	Last Date That 340B Drugs Purchased	Update	OPA Terminate		1/6/2020 12:00:00 AM	1/6/2020 2:27 PM
Details	State	Update	OPA Terminate	Active	Terminated	1/6/2020 2:27 PM
Terminations	Termination Comments	Update	OPA Terminate		The 340B Program statute requires that a family planning project receive a grant or contract under Title X to be eligible for the 340B Program. HRSA has received information from the Office of Population Affairs indicating your entity no longer receives Title X funding. As per the email sent on November 19, 2019 OPA is terminating your entity.	1/6/2020 2:27 PM
Terminations	Termination Date	Update	OPA Terminate		1/6/2020 12:00:00 AM	1/6/2020 2:27 PM
Terminations	Termination Effective Date	Update	OPA Terminate		1/6/2020 12:00:00 AM	1/6/2020 2:27 PM
Terminations	Termination Reason	Update	OPA Terminate		Loss of qualifying grant/support	1/6/2020 2:27 PM
Contacts	Authorizing Official	Update	Change Request	Rodriguez, Yamelsie Chief Operating Officer Planned Parenthood of Illinois 3125926817	Powell, Richard Chief Financial Officer Planned Parenthood of Illinois 3125926878	7/17/2019 10:34 AM
Contacts	Authorizing Official	Update	Profile Change Request	Rodriguez, Yamelsie VP Patient Services Planned Parenthood of Illinois 3125926817	Rodriguez, Yamelsie Chief Operating Officer Planned Parenthood of Illinois 3125926817	6/7/2019 12:28 PM
Contacts	Signed By	Update	Profile Change Request	Rodriguez, Yamelsie VP Patient Services Planned Parenthood of Illinois 3125926817	Rodriguez, Yamelsie Chief Operating Officer Planned Parenthood of Illinois 3125926817	6/7/2019 12:28 PM
Contacts	Primary Contact	Update	Recertification	Iversen, Christine Senior Director of Patient Safety and QA Planned Parenthood of Illinois 3125926867	Glover, Emily Senior Director, Patient Services Planned Parenthood of Illinois 3125926800	6/7/2019 12:23 PM
Details	Last Recertification Date	Update	Recertification	5/3/2018 2:56:11 PM	6/7/2019 12:23:13 PM	6/7/2019 12:23 PM
Details	Grant Number	Update	Recertification	FPHPA056209	FPHPA006456-01-00	6/7/2019 12:23 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	5/3/2018 2:56 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		362170901004	5/3/2018 2:56 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		IL	5/3/2018 2:56 PM
Contacts	Primary Contact	Update	Recertification	Ramos, Haydee Regional Director of Health Center Operations Planned Parenthood of Illinois 3125926882	Iversen, Christine Senior Director of Patient Safety and QA Planned Parenthood of Illinois 3125926867	5/3/2018 2:56 PM
Details	Last Recertification Date	Update	Recertification	5/13/2017 12:00:00 AM	5/3/2018 2:56:11 PM	5/3/2018 2:56 PM
Contacts	Primary Contact	Update	New Registration	Ramos, Haydee Regional Director of Health Center Operations 3125926882	Ramos, Haydee Regional Director of Health Center Operations Planned Parenthood of Illinois 3125926882	4/11/2018 5:52 PM
Contacts	Authorizing Official	Update		Rodriguez, Yamelsie VP Patient Services 3125926817	Rodriguez, Yamelsie VP Patient Services Planned Parenthood of Illinois 3125926817	10/4/2017 5:00 PM
Contacts	Signed By	Update		Rodriguez, Yamelsie VP Patient Services 3125926817	Rodriguez, Yamelsie VP Patient Services Planned Parenthood of Illinois 3125926817	10/4/2017 5:00 PM
Contacts	Primary Contact	Insert			Ramos, Haydee Regional Director of Health Center Operations 3125926882	6/19/2017 12:41 PM
Contacts	Authorizing Official	Insert			Rodriguez, Yamelsie VP Patient Services 3125926817	6/19/2017 12:41 PM
Contacts	Signed By	Insert			Rodriguez, Yamelsie VP Patient Services 3125926817	6/19/2017 12:41 PM
Addresses	Main Address	Insert			1200 N LaSalle Ave Chicago, IL 60610	5/13/2017 12:57 PM
Details	Last Recertification Date	Update		5/13/2016 12:00:00 AM	5/13/2017 12:00:00 AM	5/13/2017 12:57 PM
Details	Last Recertification Date	Update			5/13/2016 12:00:00 AM	5/13/2016 3:59 PM
Dates	Participating Approval Date	Update			11/19/2015 12:00:00 AM	11/19/2015 12:15 PM
Details	State	Update		Pending	Active	11/19/2015 12:15 PM
Dates	Start Date	Update			1/1/2016 12:00:00 AM	11/19/2015 12:15 PM
Details	340B ID	Update		ONLINE_REG_54165	FP60610	11/19/2015 7:15 AM
Details	Entity Name	Update		Planned Parenthood of Illinois- Near North Health Center	Planned Parenthood of Illinois	11/19/2015 7:15 AM
Details	Entity Subname	Update			Near North Health Center	11/19/2015 7:15 AM
Details	340B ID	Update		ONLINE_REG	ONLINE_REG_54165	10/1/2015 11:45 AM
Medicaid Billing	NPI: Number	Insert			1790754745	10/1/2015 11:45 AM
Details	Last Recertification Date	Insert				10/1/2015 11:45 AM
Details	Grant Number	Insert			FPHPA056209	10/1/2015 11:45 AM
Details	340B ID	Insert			ONLINE_REG	10/1/2015 11:45 AM
Details	Is Authorizing Official EHB Data	Insert				10/1/2015 11:45 AM
Dates	Last Date That 340B Drugs Purchased	Insert				10/1/2015 11:45 AM
Details	Medicare Provider Number	Insert				10/1/2015 11:45 AM
Details	Entity Name	Insert			Planned Parenthood of Illinois- Near North Health Center	10/1/2015 11:45 AM
Details	Program Code	Insert			FP	10/1/2015 11:45 AM
Details	Entity Subname	Insert				10/1/2015 11:45 AM
Dates	Participating Approval Date	Insert				10/1/2015 11:45 AM
Details	State	Insert			Pending	10/1/2015 11:45 AM
Dates	Registration Date	Insert			10/1/2015 12:00:00 AM	10/1/2015 11:45 AM
Dates	Signed By Date	Insert			10/1/2015 12:00:00 AM	10/1/2015 11:45 AM
Dates	Start Date	Insert				10/1/2015 11:45 AM
Terminations	Termination Comments	Insert				10/1/2015 11:45 AM
Terminations	Termination Date	Insert				10/1/2015 11:45 AM
Terminations	Termination Effective Date	Insert				10/1/2015 11:45 AM
Terminations	Termination Reason	Insert				10/1/2015 11:45 AM

340B Drug Pricing Program Database

Comments

Medicaid Billing

Shipping Addresses

Contract Pharmacies

History