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CH05758P UNIVERSITY OF ILLINOIS (Terminated)
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Main Details
Name
UNIVERSITY OF ILLINOIS
Subdivision Name
Mile Square Englewood STEM-Cook Satellite
Type
HRSA-Funded Health Center
Site ID
BPS-H80-018940
340B ID
CH05758P
Grant Number
H80CS00324
Additional Details
Current Program Status
Terminated
Registration Date
7/7/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/13/2017
Last Recertification Date
2/14/2023
Termination Date
Termination Reason
4/1/2024
Site closure
Contacts
Authorizing Official
University of Illinois at Chicago
Michael Moss, Associate Vice Chancellor, Budget & Financial Analysis
(312) 996-0306
Primary Contact
UI Health Mile Square Health Center
Kimary Lee, Senior Director Compliance and Development
(312) 413-0278
Addresses
Street Address
8150 South Bishop
Chicago, IL 60620
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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