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HV616561B UI Health Community Clinic Network (Active)
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Main Details
Name
UI Health Community Clinic Network
Subdivision Name
Northwest Side (Humboldt Park)
Type
Ryan White Part C
340B ID
HV616561B
Grant Number
H76HA00686
Additional Details
Current Program Status
Active
Registration Date
7/3/2019
Participating Start Date
10/1/2019
Participating Approval Date
7/23/2019
Last Recertification Date
2/27/2025
Time Period the Assistance was Received
5/1/2022 - 4/30/2025
Contacts
Authorizing Official
University of Illinois - Chicago
Richard M. Novak, Chief, Division of Infectious Diseases/Ryan White Part A and C Project Director
(312) 996-6763
Primary Contact
University of Illinois - Chicago
Ted Ebersold, Director, Administrative Operations
(312) 996-1235
Addresses
Street Address
5225 W Madison
Chicago, IL 60644
Billing Address
Division of Infectious Diseases/UCCN
808 S. Wood Street/ MC 735
Room 888
Chicago, IL 60612
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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