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CH05758D University of Illinois (Terminated)
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Main Details
Name
University of Illinois
Subdivision Name
Mile Square Health Center, Young Women's Leadership/Drake Health and Wellness Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-006064
340B ID
CH05758D
Grant Number
H80CS00324
Additional Details
Current Program Status
Terminated
Registration Date
10/12/2012
Participating Start Date
1/1/2013
Participating Approval Date
10/22/2012
Last Recertification Date
2/19/2019
Termination Date
Termination Reason
1/1/2020
Site closure
Contacts
Authorizing Official
University of Illinois at Chicago
Michael Moss, Associate Vice Chancellor, Budget & Financial Analysis
(312) 996-0306
Primary Contact
Mile Square Health Center
Sima Shah, 340B Compliance Coordinator/Clinical Assistant Professor
(312) 996-3692
Addresses
Street Address
2641 South Calumet Avenue
Chicago, IL 60616-2901
Billing Address
University of Illinois
Invoice Processing Center
PO Box 820
Rantoul, IL 61866
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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10/22/12 - Reviewed registration and forwarded to IS for approval.
10/22/2012
April 2025
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