340B Drug Pricing Program Database
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DSH140182 ADVOCATE NORTH SIDE HEALTH NETWORK (Active)
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Main Details
Name
ADVOCATE NORTH SIDE HEALTH NETWORK
Subdivision Name
DBA ADVOCATE ILLINOIS MASONIC MEDICAL CENTER (AIMMC)
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH140182
Medicare Provider Number
140182
Additional Details
Current Program Status
Active
Registration Date
10/27/2005
Participating Start Date
10/27/2005
Participating Approval Date
10/27/2005
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Advocate Aurora Health Care
Nan Nelson, SVP-Finance
(414) 378-4765
Primary Contact
Advocate Aurora Health
Jason G Nowak, Director, Pharmacy 340B Program
(414) 640-8457
Addresses
Street Address
836 West Wellington Ave.
CHICAGO, IL 60657
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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1/18/12 remove Medicaid info JH
01/18/2012
May 2025
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