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CH05175BD ACCESS COMMUNITY HEALTH NETWORK (Active)
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Main Details
Name
ACCESS COMMUNITY HEALTH NETWORK
Subdivision Name
ACCESS Martin T. Russo Family Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-010968
340B ID
CH05175BD
Grant Number
H80CS00834
Additional Details
Current Program Status
Active
Registration Date
10/1/2003
Participating Start Date
10/1/2003
Participating Approval Date
9/26/2003
Last Recertification Date
2/13/2025
Contacts
Authorizing Official
Access Community Health Network
Mahomed Ouedraogo, Chief Executive Officer
(312) 526-2360
Primary Contact
Access Community Health Network
Kenneth Pacheco, Director, Pharmacy and Lab Services
(312) 526-2107
Addresses
Street Address
245 S Gary Ave
Lower Level
Bloomingdale, IL 60108-2228
Billing Address
ACCESS COMMUNITY HEALTH NETWORK
600 W Fulton St
Suite 300
CHICAGO, IL 60661
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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12/14/11 - Changed address from 235 SOUTH GARY AVENUE. 2/17/11 UPDATED PHYS ADD (WAS 245 SOUTH GARY AVENUE, SUITE 201); 7/13/10 ADDED BILL TO; NEW SITE ADDED 10/01/2003
12/14/2011
2/17/11 UPDATED PHYS ADD (WAS 245 SOUTH GARY AVENUE, SUITE 201); 7/13/10 ADDED BILL TO; NEW SITE ADDED 10/01/2003
02/17/2011
2/17/11 UPDATED PHYS ADD (WAS 245 SOUTH GARY AVENUE, SUITE 201); 7/13/10 ADDED BILL TO; NEW SITE ADDED 10/01/2003
02/17/2011
April 2025
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