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DSH140304 UChicago Medicine AdventHealth Bolingbrook (Active)
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Main Details
Name
UChicago Medicine AdventHealth Bolingbrook
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH140304
Medicare Provider Number
140304
Additional Details
Current Program Status
Active
Registration Date
9/18/2009
Participating Start Date
10/1/2009
Participating Approval Date
9/21/2009
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
UChicago Medicine AdventHealth Bolingbrook
Tristan R Shaw, CFO
(630) 312-6008
Primary Contact
UChicago Medicine AdventHealth Bolingbrook
DAVID TSANG, 340B PROGRAM DIRECTOR
(847) 372-8408
Addresses
Street Address
500 REMINGTON BLVD.
BOLINGBROOK, IL 60440-4988
Billing Address
UChicago Medicine AdventHealth Bolingbrook
c/o AdventHealth
902 Inspiration Avenue
Suite 9100
Altamonte Springs, FL 32714
Comments
Medicaid Billing
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Contract Pharmacies
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