340B Drug Pricing Program Database
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DSH140182N ADVOCATE NORTH SIDE HEALTH NETWORK (Active)
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Main Details
Name
ADVOCATE NORTH SIDE HEALTH NETWORK
Subdivision Name
ADVOCATE ILLINOIS MASONIC - Park Ridge Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH140182N
Medicare Provider Number
140182
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/2/2020
Participating Start Date
7/1/2020
Participating Approval Date
4/7/2020
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Advocate Aurora Health Care
Nan Nelson, SVP-Finance
(414) 378-4765
Primary Contact
Advocate Aurora Health
Jason G Nowak, Director, Pharmacy 340B Program
(414) 640-8457
Addresses
Street Address
1700 Luther Lane
2200
Park Ridge, IL 60068
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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