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FP606121 UNIVERSITY OF ILLINOIS AT CHICAGO (Terminated)
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Main Details
Name
UNIVERSITY OF ILLINOIS AT CHICAGO
Subdivision Name
CENTER FOR WOMEN'S HEALTH
Type
Family Planning (Title X only)
340B ID
FP606121
Grant Number
FPHPA056139
Additional Details
Current Program Status
Terminated
Registration Date
1/1/1998
Participating Start Date
1/1/1998
Participating Approval Date
8/8/2003
Last Recertification Date
6/8/2015
Termination Date
Termination Reason
7/1/2016
Site closure
Contacts
Authorizing Official
Gloria Elam, Authorizing Agent
(312) 996-7430
Primary Contact
Sami Labib, Assistant Director of Pharmacy
(312) 996-9600
Addresses
Street Address
M/C 650
1801 W TAYLOR ST, #4C
CHICAGO, IL 60612
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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1/13/2010 CONTRACT PHARMACY ADDRESS (WAS 1855 WEST TAYLOR, MC648); 10/27/05 - ADDR UPDATE
03/10/2010
May 2025
May 2025
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