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DSH140088R THE UNIVERSITY OF CHICAGO MEDICAL CENTER (Active)
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Main Details
Name
THE UNIVERSITY OF CHICAGO MEDICAL CENTER
Subdivision Name
University of Chicago Medicine - Crown Point Infusion
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH140088R
Medicare Provider Number
140088
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/8/2024
Participating Start Date
1/1/2025
Participating Approval Date
10/21/2024
Last Recertification Date
Contacts
Authorizing Official
The University of Chicago Medical Center
Denise Scarpelli, Vice President, Chief Pharmacy Officer
(773) 834-5601
Primary Contact
The University of Chicago Medical Center
Brent E Fiedler, Director, Pharmacy Contracting, Finance, and Metrics
(773) 702-2289
Addresses
Street Address
10855 VIRGINIA ST
2100
CROWN POINT, IN 46307-0210
Billing Address
THE UNIVERSITY OF CHICAGO MEDICAL CENTER
150 HARVESTER DRIVE
BURR RIDGE, IL 60527
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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