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DSH140029K COPLEY MEMORIAL HOSPITAL (Active)
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Main Details
Name
COPLEY MEMORIAL HOSPITAL
Subdivision Name
CARDIOVASCULAR - YORKVILLE - CV - Yorkville
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH140029K
Medicare Provider Number
140029
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/15/2022
Participating Start Date
7/1/2022
Participating Approval Date
4/21/2022
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
Rush University System for Health
Kate Marie Schaafsma, VP, Chief Pharmacy Officer
(815) 592-4299
Primary Contact
Copley Memorial Hospital
Stacey Ries, Deputy General Counsel
(630) 499-4721
Addresses
Street Address
1100 W VETERANS PKWY
STE 320
YORKVILLE, IL 60560-4728
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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