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DSH140172V FRANCISCAN HEALTH OLYMPIA FIELDS & CHICAGO HEIGHTS (Terminated)
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Main Details
Name
FRANCISCAN HEALTH OLYMPIA FIELDS & CHICAGO HEIGHTS
Subdivision Name
Laboratory
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH140172V
Medicare Provider Number
140172
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/6/2016
Participating Start Date
1/1/2017
Participating Approval Date
10/27/2016
Last Recertification Date
8/29/2018
Termination Date
Termination Reason
4/1/2019
Site closure
Contacts
Authorizing Official
Franciscan Alliance
Frank J McHugh, VP Finance - CFO
(708) 747-4000 Ext: 82014
Primary Contact
Franciscan Health Olympia Fields and Chicago Heights
Kevin Karstens, Director of Pharmacy
(708) 756-1000 Ext: 56314
Addresses
Street Address
1423 Chicago Road
Chicago Heights, IL 60411-3400
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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