340B Drug Pricing Program Database
BOND DRUG COMPANY OF ILLINOIS, L.L.C.
DSH140182 ADVOCATE NORTH SIDE HEALTH NETWORK - information as of 5/13/2025 4:36:35 AM
Covered Entity Details
Entity Name
ADVOCATE NORTH SIDE HEALTH NETWORK
Subdivision Name
DBA ADVOCATE ILLINOIS MASONIC MEDICAL CENTER (AIMMC)
Type
Disproportionate Share Hospital
340B ID
DSH140182
Entity Address
836 West Wellington Ave.
CHICAGO, IL 60657
Medicare Provider Number
140182
Participating Start Date
10/27/2005
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
BOND DRUG COMPANY OF ILLINOIS, L.L.C.
Pharmacy Address
DBA: WALGREENS #13454
6140 N WESTERN AVE
CHICAGO, IL 60659
Pharmacy Comments
Contract Details
Approval Date
7/7/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nan Nelson, SVP-Finance
(414) 378-4765
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/7/2021
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