340B Drug Pricing Program Database
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DSH140088K THE UNIVERSITY OF CHICAGO MEDICAL CENTER (Terminated)
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Main Details
Name
THE UNIVERSITY OF CHICAGO MEDICAL CENTER
Subdivision Name
University of Chicago Medicine Center for Advanced Care at Orland Park - CT
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH140088K
Medicare Provider Number
140088
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/10/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/24/2017
Last Recertification Date
8/29/2024
Termination Date
Termination Reason
4/1/2025
Business decision by the Covered Entity
Contacts
Authorizing Official
The University of Chicago Medical Center
Denise Scarpelli, Vice President, Chief Pharmacy Officer
(773) 834-5601
Primary Contact
The University of Chicago Medical Center
Brent E Fiedler, Director, Pharmacy Contracting, Finance, and Metrics
(773) 702-2289
Addresses
Street Address
14290 S LaGrange Road
Suite 2101
Orland Park, IL 60462-2023
Billing Address
The University of Chicago Medical Center
150 Harvester Drive, Suite 300
Burr Ridge, IL 60527
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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