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CH05758M UNIVERSITY OF ILLINOIS (Terminated)
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Main Details
Name
UNIVERSITY OF ILLINOIS
Subdivision Name
Mile Square-Auburn Gresham Health and Wellness Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-014154
340B ID
CH05758M
Grant Number
H80CS00324
Additional Details
Current Program Status
Terminated
Registration Date
1/9/2015
Participating Start Date
4/1/2015
Participating Approval Date
1/20/2015
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
8131 S MAY ST
CHICAGO, IL 60620-3007
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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April 2025
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