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CH05313A CIRCLE FAMILY CARE (Terminated)
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Main Details
Name
CIRCLE FAMILY CARE
Subdivision Name
Type
HRSA-Funded Health Center
Site ID
BPS-H80-003483
340B ID
CH05313A
Grant Number
H80CS00400
Additional Details
Current Program Status
Terminated
Registration Date
7/1/1998
Participating Start Date
7/1/1998
Participating Approval Date
7/1/1998
Last Recertification Date
1/25/2017
Termination Date
Termination Reason
4/1/2018
Failure to recertify
Contacts
Authorizing Official
Booker Thomas, CEO
(773) 379-1000 Ext: 3009
Primary Contact
Christopher jackson, CFO
(773) 379-1000 Ext: 3013
Addresses
Street Address
4909 W. DIVISION STREET
CHICAGO, IL 60651
Billing Address
Circle Family Healthcare Network
5002 W. Madison Street
Chicago, IL 60644
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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