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WALGREEN CO.
HV60120A OPEN DOOR CLINIC OF GREATER ELGIN
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Covered Entity Details
Entity Name
OPEN DOOR CLINIC OF GREATER ELGIN
Subdivision Name
AURORA CLINIC
Type
Ryan White Part C
340B ID
HV60120A
Entity Address
157 S. Lincoln Avenue
Aurora, IL 60505
Grant Number
H76HA01704
Participating Start Date
4/1/2012
Last Recertification Date
2/28/2022
Entity Termination Date
4/1/2023
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 07100
1700 LARKIN AVE
ELGIN, IL 60123-5947
Pharmacy Comments
Contract Details
Approval Date
4/10/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
zeba s geloo, medical director
(847) 695-1093
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/10/2020
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