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CH057580 University of Illinois (Active)
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Main Details
Name
University of Illinois
Subdivision Name
University of Illinois Mile Square Health Center - IMD
Type
HRSA-Funded Health Center
Site ID
BPS-H80-013573
340B ID
CH057580
Grant Number
H80CS00324
Additional Details
Current Program Status
Active
Registration Date
1/1/2000
Participating Start Date
1/1/2000
Participating Approval Date
8/4/2004
Last Recertification Date
2/23/2025
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
Phyllis Grice, Chief Operating Officer
(312) 413-0728
Addresses
Street Address
1220 S. Wood Street
Chicago, IL 60608
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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CONTACT UPDATE
08/04/2004
May 2025
May 2025
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