Covered Entity Details

CH051516AF GREATER ELGIN FAMILY CARE CENTER (Terminated) - information as of 5/13/2025 11:01:58 PM

Main Details

Name

GREATER ELGIN FAMILY CARE CENTER

Subdivision Name

Lakewood School

Type

HRSA-Funded Health Center

Site ID

BPS-H80-014648

340B ID

CH051516AF

Grant Number

H80CS00288

Additional Details

Current Program Status

Terminated

Registration Date

10/13/2015

Participating Start Date

1/1/2016

Participating Approval Date

10/20/2015

Last Recertification Date

2/21/2017

Termination Date
Termination Reason

4/1/2018
Business decision by the Covered Entity

Contacts

Authorizing Official

Greater Family Health
ROBERT M. TANNER, PRESIDENT/CEO
(847) 608-1344 Ext: 230

Primary Contact

Greater Family Health
ROBERT M. TANNER, PRESIDENT/CEO
(847) 608-1344 Ext: 230

Addresses

Street Address

1651 RAVINE LN
CARPENTERSVILLE, IL 60110-2130

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites 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?
No

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
No records to display.

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH0515160	Active	BPS-H80-001778	Greater Family Health	370 Summit St	370 Summit St	Elgin	IL
CH051516A	Active	BPS-H80-001571	Greater Family Health	450 Dundee Ave	450 Dundee Ave	Elgin	IL
CH051516AA	Terminated	BPS-H80-004376	GREATER ELGIN FAMILY CARE CENTER	ELLIS MIDDLE SCHOOL	225 S Liberty St	Elgin	IL
CH051516AB	Terminated	BPS-H80-003735	GREATER ELGIN FAMILY CARE CENTER	GEFCC ELGIN COMMUNITY COLLEGE	1770 Spartan Dr	Elgin	IL
CH051516AC	Terminated	BPS-H80-006890	GREATER ELGIN FAMILY CARE CENTER	Ronald D. O'Neal	510 Franklin Blvd	Elgin	IL
CH051516AD	Active	BPS-H80-015051	Greater Family Health	300 McHenry Rd	300 MCHENRY RD	WHEELING	IL
CH051516AE	Active	BPS-H80-014720	Greater Family Health	1515 E. Lake St.	1515 E LAKE ST	HANOVER PARK	IL
CH051516AF	Terminated	BPS-H80-014648	GREATER ELGIN FAMILY CARE CENTER	Lakewood School	1651 RAVINE LN	CARPENTERSVILLE	IL
CH051516AG	Active	BPS-H80-012954	Greater Family Health	165 E. Plank Rd.	165 E Plank Rd	Sycamore	IL
CH051516AH	Active	BPS-H80-012953	Greater Family Health	2550 N. Annie Glidden Rd.	2550 N Annie Glidden Rd	Dekalb	IL
CH051516AJ	Active	BPS-H80-034114	Greater Family Health	345 W. Northwest Highway, Palatine, IL 60067	345 W Northwest Hwy	Palatine	IL
CH051516AK	Active	BPS-H80-034175	Greater Family Health	10225 Grand Avenue, Franklin Park, IL 60131	10225 Grand Ave	Franklin Park	IL
CH051516B	Active	BPS-H80-021633	Greater Family Health	373 Summit St.	373 Summit St	Elgin	IL
CH051516C	Terminated	BPS-H80-008506	GREATER ELGIN FAMILY CARE CENTER	McHenry County Community Health Center	4100 Veterans Parkway	McHenry	IL
CH051516D	Active	BPS-H80-011742	Greater Family Health	135 Irving Park Road	135 Irving Park Road	Streamwood	IL
CH051516E	Active	BPS-H80-010982	Greater Family Health	3901 Mercy Dr.	3901 Mercy Drive	McHenry	IL
CH051516F	Active	BPS-H80-030073	Greater Family Health	1435 N. Randall Rd	1435 N Randall Rd	Elgin	IL
CH051516G	Terminated	BPS-H80-005801	GREATER ELGIN FAMILY CARE CENTER	HIGHLAND ELEMENTARY SCHOOL	190 N Melrose Ave	Elgin	IL
CH051516H	Terminated	BPS-H80-007333	GREATER ELGIN FAMILY CARE CENTER	HARRIET GIFFORD ELEMN. SCHOOL	240 S Clifton Ave	Elgin	IL
CH051516J	Terminated	BPS-H80-008111	GREATER ELGIN FAMILY CARE CENTER	Sunnydale Elementary School	716 Sunnydale Blvd	Streamwood	IL
CH051516K	Terminated	BPS-H80-009128	GREATER ELGIN FAMILY CARE CENTER	Channing Elementary School	63 S Channing St	Elgin	IL
CH051516L	Terminated	BPS-H80-009135	GREATER ELGIN FAMILY CARE CENTER	Parkwood Elementary School	2150 Laurel Ave	Hanover Park	IL
CH051516M	Terminated	BPS-H80-009082	GREATER ELGIN FAMILY CARE CENTER	Ontarioville Elementary School	2100 Elm Street	Hanover Park	IL
CH051516N	Terminated	BPS-H80-009136	GREATER ELGIN FAMILY CARE CENTER	Lords Park Elementary School	323 Waverly Dr	Elgin	IL
CH051516P	Terminated	BPS-H80-009137	GREATER ELGIN FAMILY CARE CENTER	deLacey Family Education Center	50 Cleveland Ave	Carpentersville	IL
CH051516Q	Terminated	BPS-H80-009134	GREATER ELGIN FAMILY CARE CENTER	Lowrie Elementary School	264 Oak St	Elgin	IL
CH051516R	Terminated	BPS-H80-009336	GREATER ELGIN FAMILY CARE CENTER	Laurel Hill Elementary School	1750 Laurel Ave	Hanover Park	IL
CH051516S	Terminated	BPS-H80-003416	GREATER ELGIN FAMILY CARE CENTER	GEFCC-PADS OF ELGIN	1730 Berkley St	Elgin	IL
CH051516T	Terminated	BPS-H80-006896	GREATER ELGIN FAMILY CARE CENTER	ELGIN HIGH SCHOOL	1200 Maroon Dr	Elgin	IL
CH051516U	Terminated	BPS-H80-007189	GREATER ELGIN FAMILY CARE CENTER	ABBOTT MIDDLE SCHOOL	949 Van St	Elgin	IL
CH051516V	Terminated	BPS-H80-002981	GREATER ELGIN FAMILY CARE CENTER	GARFIELD ELEMENTARY SCHOOL	420 May St	Elgin	IL
CH051516W	Terminated	BPS-H80-005906	GREATER ELGIN FAMILY CARE CENTER	LARKIN HIGH SCHOOL	1475 Larkin Ave	Elgin	IL
CH051516X	Terminated	BPS-H80-005043	GREATER ELGIN FAMILY CARE CENTER	GRTR ELGIN @ HUFF ELEMENTARY SBH	801 Hastings St	Elgin	IL
CH051516Z	Terminated	BPS-H80-007227	GREATER ELGIN FAMILY CARE CENTER	LARSEN MIDDLE SCHOOL	665 Dundee Ave	Elgin	IL

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 02447	2040 ARMY TRAIL ROAD	HANOVER PARK	IL	60133	10/01/2016
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 02986	815 SUMMIT	ELGIN	IL	60120	10/01/2016
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 03406	100 N RANDALL RD	LAKE IN THE HILLS	IL	60156	10/01/2016
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 03433	2560 W GOLF RD	HOFFMAN ESTATES	IL	60169	10/01/2016
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 03729	7350 BARRINGTON RD.	HANOVER PARK	IL	60133	10/01/2016
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 03927	13 E IRVING PARK RD	STREAMWOOD	IL	60107	10/01/2016
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 03993	540 N SCHMALE RD	CAROL STREAM	IL	60188	10/01/2016
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04040	500 NW HIGHWAY	CARY	IL	60013	10/01/2016
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04042	100 W. LINCOLN HWY	DEKALB	IL	60115	10/01/2016
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04150	230 W. CHRYSLER DR.	BELVIDERE	IL	61008	10/01/2016
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04179	2100 W. STATE	GENEVA	IL	60134	10/01/2016
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04258	810 W. MAIN ST.	WEST DUNDEE	IL	60118	10/01/2016
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04463	1201 W SPRING ST	SOUTH ELGIN	IL	60177	10/01/2016
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04502	399 LAKE MARIAN ROAD	CARPENTERSVILLE	IL	60110	10/01/2016
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05284	1301 E ALGONQUIN RD	ALGONQUIN	IL	60102	10/01/2016
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05366	5500 COUNTY FARM RD	HANOVER PARK	IL	60133	10/01/2016
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05469	3925 W ELM STREET	MCHENRY	IL	60050-4361	10/01/2016
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05520	270 W LAKE STREET	BLOOMINGDALE	IL	60108	10/01/2016
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 12772	589 N. MCLEAN BLVD.	ELGIN	IL	60123	10/01/2016
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 15482	899 S. IL ROUTE 59	BARTLETT	IL	60103	10/01/2016
CH051516A	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04941	10 N. MILWAUKEE AVE.	WHEELING	IL	60090	04/01/2018
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04941	10 N. MILWAUKEE AVE.	WHEELING	IL	60090	07/01/2018
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 03940	375 E DUNDEE RD	PALATINE	IL	60074	07/01/2018
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04067	15 N BUFFALO GROVE RD	BUFFALO GROVE	IL	60089	04/01/2020
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 03320	61 SOUTH ROUTE 12	FOX LAKE	IL	60020	10/01/2020
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 12623	1180 S ROSELLE RD	SCHAUMBURG	IL	60193	10/01/2020
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04146	1 N. ELMHURST ROAD	PROSPECT HEIGHTS	IL	60070	07/01/2022
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04826	9800 IRVING PARK ROAD	SCHILLER PARK	IL	60176	07/01/2022
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 03512	1711 W CAMPBELL ST	ARLINGTON HEIGHTS	IL	60005	07/01/2022
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04277	602 W. LIBERTY ST.	WAUCONDA	IL	60084	07/01/2022
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04355	12 N NORTHWEST HIGHWAY	PALATINE	IL	60067	07/01/2022
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04464	910 NORTH RAND RD.	LAKE ZURICH	IL	60047	07/01/2022
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 02213	1285 S RAND ROAD	LAKE ZURICH	IL	60047	07/01/2022
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05107	1701 E KENSINGTON RD	MT PROSPECT	IL	60056	07/01/2022
CH051516E	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04463	1201 W SPRING ST	SOUTH ELGIN	IL	60177	01/01/2024
CH051516AH	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 02986	815 SUMMIT	ELGIN	IL	60120	01/01/2024
CH051516AE	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 03729	7350 BARRINGTON RD.	HANOVER PARK	IL	60133	01/01/2024
CH051516AG	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 05469	3925 W ELM STREET	MCHENRY	IL	60050-4361	01/01/2024
CH051516AK	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04502	399 LAKE MARIAN ROAD	CARPENTERSVILLE	IL	60110	01/01/2024
CH051516A	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 03927	13 E IRVING PARK RD	STREAMWOOD	IL	60107	01/01/2024
CH051516D	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 03433	2560 W GOLF RD	HOFFMAN ESTATES	IL	60169	01/01/2024
CH051516B	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04042	100 W. LINCOLN HWY	DEKALB	IL	60115	01/01/2024
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04988	1701 N BUFFALO GROVE RD	BUFFALO GROVE	IL	60089	04/01/2024
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 04940	305 W ROLLINS RD	ROUND LAKE BEACH	IL	60073	04/01/2024
CH0515160	BOND DRUG COMPANY OF ILLINOIS, L.L.C.	DBA: WALGREENS # 03995	6 E NORTH AVE	NORTHLAKE	IL	60164	04/01/2024
CH0515160	GREENBROOK PHARMACY LLC	GREENBROOK PHARMACY	1806 IRVING PARK RD	HANOVER PARK	IL	60133	08/08/2012	09/01/2015
CH0515160	KEDVON PHARMACY INTEGRATIONS INC.	770 S BUFFALO GROVE RD		BUFFALO GROVE	IL	60089	01/01/2016
CH0515160	KEDVON PHARMACY SOLUTIONS, INC.	56 S MILWAUKEE AVE		WHEELING	IL	60090-3108	01/01/2016
CH0515160	LEHAN DRUGS INC	1407 S 4TH ST		DEKALB	IL	60115	10/01/2014
CH0515160	QOL MEDS LLC		4100 VETERANS PKWY	MCHENRY	IL	60050	09/19/2011
CH0515160	SCAL INC	DBA MEDICINE STOP OF ELGIN	860 SUMMIT ST STE 112	ELGIN	IL	60120	07/12/2006
CH0515160	WALGREEN CO	DBA: WALGREENS #06764	2155 RANDALL RD	CARPENTERSVILLE	IL	60110	10/01/2016
CH051516A	WALGREEN CO	DBA: WALGREENS #10971	442 W STATE RD	ISLAND LAKE	IL	60042	04/01/2018
CH0515160	WALGREEN CO	DBA: WALGREENS #10971	442 W STATE RD	ISLAND LAKE	IL	60042	07/01/2018
CH0515160	WALGREEN CO	DBA: WALGREENS #07769	7880 WINN RD	SPRING GROVE	IL	60081	04/01/2020
CH0515160	Walgreen CO	DBA Walgreens Central Fill #21417	599 S Schmidt Rd Ste A	Bolingbrook	IL	60440-9405	07/01/2023
CH0515160	WALGREEN CO.	DBA: WALGREENS # 01994	305 SOUTH EASTWOOD DR	WOODSTOCK	IL	60098	10/01/2016
CH0515160	WALGREEN CO.	DBA: WALGREENS # 05603	1340 DEKALB AVE	SYCAMORE	IL	60178	10/01/2016
CH0515160	WALGREEN CO.	DBA: WALGREENS # 05609	1199 W DUNDEE ROAD	WHEELING	IL	60090	10/01/2016
CH0515160	WALGREEN CO.	DBA: WALGREENS # 05735	641 MEACHAM RD	ELK GROVE VILLAGE	IL	60007	10/01/2016
CH0515160	WALGREEN CO.	DBA: WALGREENS # 06746	151 NORTHWEST HWY	CRYSTAL LAKE	IL	60014	10/01/2016
CH0515160	WALGREEN CO.	DBA: WALGREENS # 06760	1000 N ROSELLE RD	HOFFMAN ESTATES	IL	60169	10/01/2016
CH0515160	WALGREEN CO.	DBA: WALGREENS # 06795	3351 W MAIN STREET	ST CHARLES	IL	60175	10/01/2016
CH0515160	WALGREEN CO.	DBA: WALGREENS # 06796	290 RANDALL ROAD	SOUTH ELGIN	IL	60177	10/01/2016
CH0515160	WALGREEN CO.	DBA: WALGREENS # 07100	1700 LARKIN AVE	ELGIN	IL	60123-5947	10/01/2016
CH0515160	WALGREEN CO.	DBA: WALGREENS # 07457	12000 PRINCETON DRIVE	HUNTLEY	IL	60142	10/01/2016
CH0515160	WALGREEN CO.	DBA: WALGREENS # 07545	1461 W SCHAUMBURG RD	SCHAUMBURG	IL	60194	10/01/2016
CH0515160	WALGREEN CO.	DBA: WALGREENS # 09059	4001 W ALGONQUIN RD	ALGONQUIN	IL	60102	10/01/2016
CH0515160	WALGREEN CO.	DBA: WALGREENS # 09439	600 VILLA ST	ELGIN	IL	60120-6720	10/01/2016
CH0515160	WALGREEN CO.	DBA: WALGREENS # 09505	445 E MAPLE AVE	ROSELLE	IL	60172-2203	10/01/2016
CH0515160	WALGREEN CO.	DBA: WALGREENS #11739	9950 N. IL ROUTE 47	HUNTLEY	IL	60142	10/01/2016
CH0515160	WALGREEN CO.	DBA: WALGREENS #13591	1435 N RANDALL RD, STE 101	ELGIN	IL	60123	10/01/2016	11/13/2019
CH051516A	WALGREEN CO.	DBA WALGREENS #11367	28895 W. IL ROUTE 120	LAKEMOOR	IL	60051	04/01/2018
CH0515160	WALGREEN CO.	DBA WALGREENS #11367	28895 W. IL ROUTE 120	LAKEMOOR	IL	60051	07/01/2018
CH0515160	WALGREEN CO.	DBA: WALGREENS #11411	395 S. DIVISION ST.	HARVARD	IL	60033-3258	04/01/2020
CH0515160	WALGREEN CO.	DBA: WALGREENS # 07754	805 W EUCLID AVENUE	PALATINE	IL	60067-7301	07/01/2022
CH0515160	WALGREEN CO.	DBA: WALGREENS # 06462	9595 GRAND AVE	FRANKLIN PARK	IL	60131	07/01/2022
CH0515160	WALGREEN CO.	DBA: WALGREENS # 09600	1445 W NORTH AVE	MELROSE PARK	IL	60160	07/01/2022
CH0515160	WALGREEN CO.	DBA: WALGREENS # 09506	770 EAST SCHAUMBURG ROAD	SCHAUMBURG	IL	60194	07/01/2022
CH0515160	WALGREEN CO.	DBA: WALGREENS # 00039	235 E PALATINE RD	ARLINGTON HEIGHTS	IL	60004	07/01/2022
CH0515160	WALGREEN CO.	DBA: WALGREENS # 09246	1000 E NORTHWEST HWY	ARLINGTON HEIGHTS	IL	60004-6235	07/01/2022
CH0515160	WALGREEN CO.	DBA: WALGREENS # 00829	8361 BELMONT AVE	RIVER GROVE	IL	60171	07/01/2022
CH0515160	WALGREEN CO.	DBA: WALGREENS # 00209	1028 S ELMHURST ROAD	MT PROSPECT	IL	60056	07/01/2022
CH0515160	WALGREEN CO.	DBA: WALGREENS # 05832	1225 W DUNDEE RD	BUFFALO GROVE	IL	60089	07/01/2022
CH0515160	WALGREEN CO.	DBA: WALGREENS # 05594	3 E GOLF RD	ARLINGTON HEIGHTS	IL	60005	07/01/2022
CH0515160	WALGREEN CO.	WALGREENS SPECIALTY PHARMACY #13832	4339 DIPAOLO CENTER	GLENVIEW	IL	60025	07/01/2023
CH0515160	WALGREEN CO.	WALGREENS SPECIALTY PHARMACY #21184	5503 E STATE ST	ROCKFORD	IL	61108	07/01/2023
CH051516AJ	WALGREEN CO.	WALGREENS SPECIALTY PHARMACY #13832	4339 DIPAOLO CENTER	GLENVIEW	IL	60025	01/01/2024
CH051516AD	WALGREEN CO.	DBA: WALGREENS # 07100	1700 LARKIN AVE	ELGIN	IL	60123-5947	01/01/2024
CH051516F	WALGREEN CO.	DBA: WALGREENS # 05603	1340 DEKALB AVE	SYCAMORE	IL	60178	01/01/2024
CH0515160	WALGREEN CO.	DBA: WALGREENS # 05711	17 W GOLF ROAD	DES PLAINES	IL	60016	04/01/2024
CH0515160	WALGREEN CO.	DBA; WALGREENS #11944	315 N IL ROUTE 31	CRYSTAL LAKE	IL	60012	04/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Authorizing Official	Update	Profile Change Request	TANNER, ROBERT M. PRESIDENT/CEO Greater Elgin Family Care Center 8476081344-230	TANNER, ROBERT M. PRESIDENT/CEO Greater Family Health 8476081344-230	2/15/2023 11:36 AM
Contacts	Primary Contact	Update	Profile Change Request	TANNER, ROBERT M. PRESIDENT/CEO Greater Elgin Family Care Center 8476081344-230	TANNER, ROBERT M. PRESIDENT/CEO Greater Family Health 8476081344-230	2/15/2023 11:36 AM
Contacts	Signed By	Update	Profile Change Request	TANNER, ROBERT M. PRESIDENT/CEO Greater Elgin Family Care Center 8476081344-230	TANNER, ROBERT M. PRESIDENT/CEO Greater Family Health 8476081344-230	2/15/2023 11:36 AM
Details	State	Update		To Be Terminated	Terminated	4/1/2018 12:00 AM
Dates	Last Date That 340B Drugs Purchased	Update	Recertification		7/13/2017 12:00:00 AM	2/12/2018 9:35 AM
Details	State	Update	Recertification	Active	To Be Terminated	2/12/2018 9:35 AM
Terminations	Termination Date	Update	Recertification		4/1/2018 12:00:00 AM	2/12/2018 9:35 AM
Terminations	Termination Effective Date	Update	Recertification		7/13/2017 12:00:00 AM	2/12/2018 9:35 AM
Terminations	Termination Reason	Update	Recertification		Business decision by the Covered Entity	2/12/2018 9:35 AM
Contacts	Authorizing Official	Update		TANNER, ROBERT M. PRESIDENT/CEO 8476081344-230	TANNER, ROBERT M. PRESIDENT/CEO Greater Elgin Family Care Center 8476081344-230	2/5/2018 12:02 PM
Contacts	Primary Contact	Update		TANNER, ROBERT M. PRESIDENT/CEO 8476081344-230	TANNER, ROBERT M. PRESIDENT/CEO Greater Elgin Family Care Center 8476081344-230	2/5/2018 12:02 PM
Contacts	Signed By	Update		TANNER, ROBERT M. PRESIDENT/CEO 8476081344-230	TANNER, ROBERT M. PRESIDENT/CEO Greater Elgin Family Care Center 8476081344-230	2/5/2018 12:02 PM
Addresses	Main Address	Insert			1651 RAVINE LN CARPENTERSVILLE, IL 60110-2130	2/21/2017 3:36 PM
Contacts	Authorizing Official	Insert			TANNER, ROBERT M. PRESIDENT/CEO 8476081344-230	2/21/2017 3:36 PM
Contacts	Primary Contact	Insert			TANNER, ROBERT M. PRESIDENT/CEO 8476081344-230	2/21/2017 3:36 PM
Contacts	Signed By	Insert			TANNER, ROBERT M. PRESIDENT/CEO 8476081344-230	2/21/2017 3:36 PM
Details	Last Recertification Date	Update		3/7/2016 12:00:00 AM	2/21/2017 12:00:00 AM	2/21/2017 3:36 PM
Details	Last Recertification Date	Update			3/7/2016 12:00:00 AM	3/7/2016 4:15 PM
Dates	Participating Approval Date	Update			10/20/2015 12:00:00 AM	10/20/2015 5:56 PM
Details	State	Update		Pending	Active	10/20/2015 5:56 PM
Dates	Start Date	Update			1/1/2016 12:00:00 AM	10/20/2015 5:56 PM
Details	340B ID	Update		ONLINE_REG_55191	CH051516AF	10/13/2015 2:32 PM
Details	340B ID	Update		ONLINE_REG	ONLINE_REG_55191	10/13/2015 10:58 AM
Details	Last Recertification Date	Insert				10/13/2015 10:58 AM
Details	Grant Number	Insert			H80CS00288	10/13/2015 10:58 AM
Details	340B ID	Insert			ONLINE_REG	10/13/2015 10:58 AM
Details	Is Authorizing Official EHB Data	Insert			False	10/13/2015 10:58 AM
Dates	Last Date That 340B Drugs Purchased	Insert				10/13/2015 10:58 AM
Details	Medicare Provider Number	Insert				10/13/2015 10:58 AM
Details	Entity Name	Insert			GREATER ELGIN FAMILY CARE CENTER	10/13/2015 10:58 AM
Details	Program Code	Insert			CH	10/13/2015 10:58 AM
Details	Entity Subname	Insert			Lakewood School	10/13/2015 10:58 AM
Dates	Participating Approval Date	Insert				10/13/2015 10:58 AM
Details	State	Insert			Pending	10/13/2015 10:58 AM
Dates	Registration Date	Insert			10/13/2015 12:00:00 AM	10/13/2015 10:58 AM
Dates	Signed By Date	Insert			10/13/2015 12:00:00 AM	10/13/2015 10:58 AM
Dates	Start Date	Insert				10/13/2015 10:58 AM
Terminations	Termination Comments	Insert				10/13/2015 10:58 AM
Terminations	Termination Date	Insert				10/13/2015 10:58 AM
Terminations	Termination Effective Date	Insert				10/13/2015 10:58 AM
Terminations	Termination Reason	Insert				10/13/2015 10:58 AM

340B Drug Pricing Program Database