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WALGREEN CO
STD60603 Planned Parenthood of Illinois
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Covered Entity Details
Entity Name
Planned Parenthood of Illinois
Subdivision Name
Loop Health Center
Type
Sexually Transmitted Diseases
340B ID
STD60603
Entity Address
17 N. State Street
Suite 500
CHICAGO, IL 60602
Grant Number
NH25PS005138
Participating Start Date
10/1/2018
Last Recertification Date
5/29/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #15281
2817 N CLARK ST
CHICAGO, IL 60657
Pharmacy Comments
Contract Details
Approval Date
4/16/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2016
Contacts
Covered Entity Signing Official
Richard Zimmerman, Acting STD Section Chief
(217) 782-2747
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/16/2013
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