340B Drug Pricing Program Database
PROVIDENT HOSPITAL OF COOK COUNTY
DSH140124B JOHN H. STROGER, JR. HOSPITAL OF COOK COUNTY - information as of 6/6/2025 12:53:39 PM
Covered Entity Details
Entity Name
JOHN H. STROGER, JR. HOSPITAL OF COOK COUNTY
Subdivision Name
CORE CLINIC
Type
Disproportionate Share Hospital
340B ID
DSH140124B
Entity Address
2020 W Harrison St.
Chicago, IL 60612
Medicare Provider Number
140124
Outpatient Facility Provider Number
Participating Start Date
10/1/2013
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
PROVIDENT HOSPITAL OF COOK COUNTY
Pharmacy Address
ATTENTION PHARMACY DEPARTMENT
500 E 51ST ST
ROOM 2050
CHICAGO, IL 60615-2400
Pharmacy Comments
Contract Details
Approval Date
6/20/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
7/1/2019
Contract Comments
Contacts
Covered Entity Signing Official
Ekerete Akpan, Chief Financial Officer
(312) 864-6827
Contract Pharmacy Representative
Cook County Health & Hospitals System
CaTanya Norwood, Senior Director of Pharmacy
(312) 864-2213
Signed By Date
6/20/2019
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