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CH05758W University of Illinois (Active)
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Main Details
Name
University of Illinois
Subdivision Name
UI Health Mile Square Health Center Back of the Yards Dental
Type
HRSA-Funded Health Center
Site ID
BPS-H80-033773
340B ID
CH05758W
Grant Number
H80CS00324
Additional Details
Current Program Status
Active
Registration Date
5/4/2023
Participating Start Date
7/1/2023
Participating Approval Date
5/8/2023
Last Recertification Date
2/14/2025
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
4634 S Bishop St
Chicago, IL 60609-3240
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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