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DSH140191 INGALLS MEMORIAL HOSPITAL (Active)
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Main Details
Name
INGALLS MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH140191
Medicare Provider Number
140191
Additional Details
Current Program Status
Active
Registration Date
9/22/2005
Participating Start Date
9/22/2005
Participating Approval Date
9/22/2005
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
The University of Chicago Medical Center
Denise Scarpelli, Vice President, Chief Pharmacy Officer
(773) 834-5601
Primary Contact
Ingalls Memorial Hospital
TOM SAMEK, ASSISTANT GENERAL COUNSEL
(773) 702-4405
Addresses
Street Address
ONE INGALLS DRIVE
HARVEY, IL 60426
Billing Address
Ingalls Memorial Hospital
150 Harvester Drive
Suite 300
Burr Ridge, IL 60527
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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